青春期妇科疾病诊治进展

Progress of Diagnose and Treatment in Gynecologic Disease in Adolescence

随着社会环境的变迁,青春期妇科疾病的构成比与30年前比较有了很大的变化,概括有几大特点：1妊娠流产率逐年升高且相关并发症增多。每年约有200~400万青少年进行不安全流产,在妇科住院就医的青春期少女中,与妊娠相关者约占22%~77%。2妇科炎症及时诊治率低。由于盆腔炎的诊疗延误,部分患者在就医时已经形成盆腔脓肿。3子宫不规则出血发生率高且治疗依从性差,女中学生中月经病患病率约为57%。4妇科肿瘤治疗时更强调保留卵巢及生育功能的重要性。如何保护化疗期间的卵巢功能是目前临床研究的热点问题。5子宫内膜异位症与生殖道畸形相关性高,在解放军总医院近10年住院治疗的37例青春期子宫内膜异位症患者中,20例有生殖道畸形。

The composition and prevalence of gynecological disorders of adolescents have dramatically changed over the last 30 years. There are some characteristics ： 1 Higher rate of miscarriage and complications due to adolescent pregnancy.Approximately 2 to 4 million young unsafe abortions take place each year. Gestation related complications account for 22%-77%among the hospitalized teenage patients in the gynecological ward. 2Timely diagnosis and treatment of gynecology inflammatory diseases. Due to the delayed in diagnosis and treatment of pelvic inflammatory disease（PID）,some patients show up at the clinic with advanced pelvic abscess. 3 The high incidence of irregular uterine bleeding and poor comliance with treatment.Approximately 57% of female middle school and high school students have menstruation disorders. 4 Adolescents with gynecological neoplasms tend to seek medical consultation at a relatively later stage and undergo fertility preservation treatments.The preservation of ovarian function during chemotherapy has attracted much attentions recently. 5 The association between endometriosis and genital tract malformation is becoming more and more common. Among all the 37 hospitalized teenage endometriosis patients during the last decade in the Chinese PLA General Hospital,20 cases were combined with genital tract malformation.