After eliminating malignant lesions and controlling specific or non-specific infection, local treatment is given priority to, so that the columnar epithelium on the abscess surface is necrotic and falls off and covered with new squamous epithelium. (1) Drug therapy: There are many drug treatments for chronic cervicitis, and the commonly used ones are: 1. Local vaginal lavage and local medication: the most commonly used treatment methods. It can be washed with potassium permanganate solution of 1∶5000, bromogeramine solution of 1∶ 1000, acetic acid solution of 1% or lactic acid solution of 0.5 ~ 1%. For patients with mild symptoms, cotton swabs can be dipped in 5 ~ 10% iodine tincture or 5 ~ 10% silver nitrate solution to locally corrode the rotten surface, once a week, which can promote the healing of the rotten surface. However, attention should be paid to avoid the leakage of liquid medicine to the normal mucosa outside the lesion area. After silver nitrate is coated, gently dip it in a cotton ball with normal saline, which is rarely used now. Topical application of Chlordecone tablets (made of chloramphenicol 250mg and prednisone 5mg) was placed in the deep vagina every night or every other night, and the course of treatment was 10. Its effect is equivalent to that of general disinfectant lavage, which can be selected according to the situation. 2. Vaginal vault closure: See other therapies for details. It can be used for chronic cervicitis complicated with paracervical connective tissue inflammation, lumbosacral pain, cervical lifting pain and other diseases that seriously affect sexual life. 3. Chinese medicine lotion Jieeryin: suitable for all kinds of acute and chronic cervicitis. Its main components are Fructus Cnidii, Cortex Phellodendri, Radix Sophorae Flavescentis and Rhizoma Atractylodis. Generally, 10% liquid medicine is used for vaginal washing or sitz bath, once a day, and 1 course of treatment for two weeks. (2) Physiotherapy: It is a method with better curative effect and shortest course of treatment for cervical erosion at present. It is suitable for cases with large erosive surface and deep inflammatory infiltration. General 1 treatment can only be cured. 1. Electrocoagulation: In the past, radial electrocautery was used and the healing time was long (6 ~ 8 weeks). At present, electrocoagulation is used to iron erosion, so it is also called perm. According to the summary of 2095 cases in the Affiliated Hospital of Shandong Medical University, the effective rate of electrotherapy for cervical erosion is 1 time, which is 100%. Specific operation, first set up an electric iron and routinely disinfect vulva, vagina and cervix. Expose the cervix with colposcope, and contact the scalding head with the rotten surface, evenly ironing it, slightly exceeding the rotten surface. The depth of scalding is about 0.2cm, which can cause bleeding and slow healing; Too shallow affects the curative effect. Spray nitrofurazone powder or chlortetracycline glycerin on the wound surface after scalding. 2. Cryotherapy: It is an ultra-low temperature therapy, with liquid nitrogen as the refrigeration source and the temperature of-196℃. Select the appropriate probe according to the corrosion during treatment. In order to improve the curative effect, the freezing-dissolving-freezing method can be used, that is, freezing 1 min, rewarming for 3 minutes, and then freezing 1 min. Its advantages are simple operation, less postoperative bleeding and less neck stenosis. The disadvantage is that there are many leucorrhea after operation. 3. Laser therapy: it is a kind of hyperthermia therapy, and the temperature can reach above 700℃. It mainly carbonizes the erosive tissue into scabs, and the wound surface is covered with new squamous epithelium after the scabs fall off. The treatment of cervical erosion generally adopts infrared carbon dioxide laser with the wavelength of10.6 μ m. The preparation before treatment is the same as that before perm. Besides thermal effect, it also has the effects of pressure, photochemistry and electromagnetic field, so it has the functions of anti-inflammation (stimulating the body to produce strong defensive immune function), analgesia (making tissue edema subside and reducing chemical and mechanical stimulation to nerve endings) and promoting tissue repair (enhancing the anabolic effect of epithelial cells, promoting epithelial proliferation and accelerating wound repair), so the treatment time is short and the cure rate is high. The treatment time of physical therapy should be carried out within 3 ~ 7 days after menstruation is clean, and it is forbidden when acute genital inflammation occurs. When leucorrhea increases after physical therapy, the vulva should be kept clean, and basin bath, sexual intercourse and vaginal washing should be avoided before the wound heals (4 ~ 8 weeks after operation). If cryotherapy is performed, the patient should be asked if he has a history of heart disease before operation, and an electrocardiogram should be done if necessary. People with heart disease are not allowed in.
clinical picture
(1) Increased leucorrhea: sometimes it is the only symptom of chronic cervicitis. Usually viscous mucus or purulent mucus. Sometimes there may be bloodshot or a small amount of blood in the secretion, and there may also be contact bleeding. Due to the stimulation of leucorrhea, it can cause vulvar itching. (2) Pain: Pain often occurs in the lower abdomen or lumbosacral region, sometimes in the upper abdomen, thighs and hip joints. The pain is aggravated every time during menstruation, defecation or sexual life, especially when the inflammation spreads backward along the uterosacral ligament or along the bottom of the broad ligament, forming chronic inflammation of connective tissue beside uterus, and the pain is even worse when the cervical main ligament is thickened. Every contact with the cervix immediately causes pain in the iliac fossa and lumbosacral region, and some patients may even cause nausea and affect their sexual life. (3) Bladder and intestinal symptoms: Chronic cervicitis can spread through lymphatic channels or directly to the connective tissue around the bladder triangle, so the bladder will defecate as soon as it has urine, and it has frequent urination or dysuria, but the urine is clear and the routine urine examination is normal. In some cases, inflammation continues to spread or secondary urinary tract infection occurs through lymphatic pathway connecting cervix, bladder triangle and ureter. The incidence of chronic pyelonephritis in adult women is several times higher than that in men, which may be related to this situation. Intestinal symptoms are less than bladder symptoms, and some patients have pain when defecating. (4) Other symptoms: such as irregular menstruation, dysmenorrhea, heavy pelvic cavity, infertility, etc.
Treatment of chronic cervicitis with traditional Chinese medicine
Chronic cervicitis is difficult to cure, which brings great pain to patients. Here are some comprehensive therapies of traditional Chinese medicine, which are recommended to patients who are not satisfied with the treatment effect of simple western medicine. 1. TCM treatment. (1) Damp-heat betting performance: more leucorrhea, yellow and white or purulent, or bloodshot. Sexual pain or vaginal bleeding after sexual intercourse. Lumbago, abdominal distension, or frequent urination, pain, itching, bitter taste and dry throat. Red tongue, yellow greasy fur and slippery pulse. Chinese patent medicine: ① Fu Yanping capsules, 4 ~ 6 capsules each time, twice a day, taken with warm water. ② Uterine pills, 9g each time, 3 times a day, taken with warm water after meals. (2) Deficiency of both spleen and kidney: thin and continuous leucorrhea, lack of food and fatigue, soreness of waist and knees, dull complexion, or loose stool. Pale tongue with white or greasy coating and slow pulse. Chinese patent medicine: ① Zhi Dai Pill, 3-6g each time, 2-3 times a day, taken with warm water after meals. ② Rongkun Pill, 6 grams each time, 3 times a day, with warm water. 2. Dietotherapy (1) Wrap 9 grams of flat tofu and 2 grams of Toona sinensis white bark 12 with gauze, then add 200 ml of water and fry it into 150 ml. It usually takes 1 week to take effect. (2) Put 30g of fresh silkworm excrement (wrapped with cloth) and 30g of Coix lachryma-jobi seed into a earthen pot and add appropriate amount of water for decoction, once a day/kloc-0, for 5-7 days. (3) 6 grams of pilose antler, 30 grams of ginkgo, 30 grams of yam, and pig bladder 1. First, clean the pig bladder, mash all the medicines, put them into the pig bladder, tie the bladder mouth tightly, stew with slow fire (low fire) until cooked, add a little salt to taste, and take the medicine, meat and soup together. (4) 30 grams of Eucommia ulmoides Oliv. (Wrapped in cloth) Cook porridge with 30-60 grams of japonica rice, and eat porridge without residue. 65438 +0 dose every day, 7 ~ 8 doses continuously. 3. Self-therapy (1) First, rub with the palm, then push down the small abdomen with the palm for several times, then massage the inner thigh with the palm for several times, and apply more techniques to the pain points, with a sense of heat as the degree. Finally, after rubbing the lumbosacral region with the palm of your hand several times, knead it for 2 ~ 3 minutes to conduct heat to the lower abdomen. (2) Usage: ① Bitter ginseng suppository, with the weight of 1.2g per pill per night, is stuffed into the deep vagina. ② Funing Suppository, each pill weighs 65438±0.6g Before going to bed, clean the vagina, send Funing Suppository to the deep part of the vagina, and then send it to the vaginal opening with a walnut-sized sterile cotton ball to prevent the liquid medicine from flowing out. The above method is suitable for those with sticky leucorrhea and yellow color. (3) 3 grams of dried alum and 6 grams of Fructus Cnidii are ground into fine powder, made into pills with wax, such as the size of marbles, wrapped with sterile gauze and stuffed into vagina, and changed every day 1 until they are cured. Used for long-term treatment of incurable patients with excessive leucorrhea. (3) Fumigation and washing: 30g of Fructus Cnidii, 30g of Radix Sophorae Flavescentis, 5g of dried alum10g, and 0g of Cortex Phellodendri10g, decocted in water, fumigated first and then bathed in vagina, which is suitable for patients with sticky and yellow leucorrhea. 4. 2 ~ 3 days after life nursing treatment, there will be a large number of bloody or yellow watery secretions discharged from the vagina, and sanitary napkins are often needed, which usually stops in about 3 weeks. Excessive leucorrhea, local stimulation of vulva, can be used warm water or 1: 5000 potassium permanganate solution to clean vulva, once in the morning and once in the evening. Wear cotton underwear at ordinary times, change frequently and keep the vulva clean. Sexual intercourse is temporarily prohibited 1 ~ 2 months. Do not swim in the swimming pool. 5. Preventive measures In the acute phase, we must choose the best treatment plan to completely kill pathogenic bacteria. Traditional Chinese medicine's understanding of chronic cervicitis belongs to the category of "leukorrhea" in gynecology of traditional Chinese medicine. Its pathogenesis is that dampness affects both ren and Dai veins, making them broken and unstable. Dampness may be caused by spleen deficiency, and water will not be wet; Or because of kidney deficiency, the seal is lost; Or because of carelessness, I felt wet outside. Therefore, the disease can be divided into three types: spleen deficiency, kidney deficiency and damp-heat. Spleen deficiency type: The symptoms are large and continuous leukorrhagia, white or yellowish in color, sticky and tasteless, sallow complexion, mental fatigue, and less loose stool. The tongue is light and fat with teeth marks, white or greasy fur, and slow or weak pulse. Kidney deficiency type: it can be divided into kidney yang deficiency and kidney yin deficiency. (1) Kidney-yang deficiency type: the symptoms are excessive leukorrhagia, endless dripping, white and thin color, backache and fatigue, long urine and loose stool. Pale tongue, thin and white fur, and slow pulse. (2) Kidney-yin deficiency type: symptoms include increased leucorrhea, sticky leucorrhea, vexation and fever, dizziness and tinnitus. The tongue is red with little fur, and the pulse is thin or counted. Damp-heat type: the symptoms are excessive leucorrhea, yellow or bloodshot, sticky, foul-smelling, short yellow urine, sticky stool and burning anus. The tongue is red, the coating is yellow and greasy, and the pulse is slippery.
[Edit this paragraph] Nursing care of chronic cervicitis
Chronic cervicitis is a chronic gynecological inflammation, which can be divided into fungal and bacterial. Patients should be patient when receiving treatment. They should take medicine strictly according to the doctor's advice under the guidance of a doctor, and don't take medicine without authorization. 1. Two or three days after the treatment of chronic cervicitis, there are more bloody or yellow watery secretions in the vagina. Therefore, cotton sanitary pads can be used during the day, and new pads need to be replaced frequently. You can also wash your vulva with warm water once in the morning and once in the evening. 2. It is best to wear cotton underwear and change it frequently to keep the vulva clean. 3. Sexual intercourse is forbidden for 1-2 months, because after cervical treatment, an inflamed scab will fall off on the surface and new tissues are slowly growing out. In the process of tissue repair, if you have sexual intercourse, the new wound of the cervix will be worn or even bleeding, which will affect the curative effect.
Symptoms and etiology of chronic cervicitis;
Symptoms: The main symptom is increased leucorrhea. Due to different pathogens, the color and quantity of leucorrhea are also different. Leucorrhea can be sticky or purulent, sometimes with bloodshot or a little blood, or contact bleeding. Pain often occurs in the lower abdomen or waist bottle eggs, pelvic pain or dysmenorrhea may occur, which is often aggravated during menstruation, defecation or sexual intercourse. In addition, irregular menstruation and infertility may occur. Etiology: Chronic cervicitis occurs after acute cervicitis, or after cervical injury caused by childbirth, abortion or surgery. The main pathogens are Staphylococcus, Streptococcus, Escherichia coli and anaerobic bacteria, followed by Neisseria gonorrhoeae, Mycobacterium tuberculosis, Trichomonas and amoeba in protozoa. Under special circumstances, it is caused by chemicals and radiation. The pathological changes of this disease include cervical erosion, cervical hypertrophy, cervical polyp, cervical gland swelling, endocarditis, and the most common is cervical erosion. Chronic cervicitis often caused by childbirth, abortion or surgical operation, which is caused by bacterial infection. Insufficient hygiene attention during puerperium and menstrual period, or unclean sexual life, will also bring pathogenic bacteria into the reproductive tract, causing cervicitis.
[Edit this paragraph] Types of chronic cervicitis
1, Cervical erosion: This is the most common chronic cervicitis. It shows that the appearance of the cervix and vagina at the external opening of the cervix is a small granular red area. 2, cervical hypertrophy: due to the long-term stimulation of chronic inflammation, cervical hyperemia, edema, gland and interstitial hyperplasia, and make the cervical hypertrophy to varying degrees. 3. Cervical polyp: Under the long-term stimulation of chronic inflammation, the cervical canal mucosa proliferates locally. Because the uterus has the function of rejection, the hyperplastic mucosa gradually protrudes from the cervix and forms polyps. 4, cervical gland cyst: also known as Naboth cyst, referred to as nanocapsule. This is a small blue-white vesicle protruding from the surface of the cervix. 5, cervical endocarditis: cervicitis. Inflammation is confined to the mucosa of the cervical canal and its underlying tissues. Clinically, the cervix and vagina are smooth, but cervical hyperemia may be blocked by purulent secretions.
Dietary taboos of patients with chronic cervicitis
1, avoid sweet and greasy food: too sweet and greasy food such as candy, cream cake, eight-treasure rice, glutinous rice cake dough, lard and fat pork, sheep oil, egg yolk, these foods will help to remove dampness, reduce the therapeutic effect, and make the disease difficult to heal. Avoid drinking: wine is a warm and irritating food, which will aggravate damp heat and make the condition worse after drinking. 2, do not eat spicy fried and warm food: spicy fried food such as pepper, fennel, pepper, onion, mustard, roast chicken, fried pork chops and so on. ; Isothermal foods such as beef, mutton and dog meat are helpful to get angry and aggravate the condition. Avoid fresh hair in the sea: marine fish, crabs, shrimps, clams, mussels, oysters, abalone and other aquatic products are all hair, which is not conducive to the regression of inflammation.
[Edit this paragraph] Can chronic cervicitis be cured?
With the development of medical technology, the disease can be completely cured as long as it is treated in a regular hospital at the initial stage. There are many traditional methods to treat chronic cervicitis, including microwave, laser, electrocautery and freezing. The ulcer surface is denatured and necrotic mainly by thermal effect, and covered with stratified squamous epithelium from outside to inside. However, there are also many shortcomings in the treatment. For example, serious body surface injury and postoperative leucorrhea. After treatment, there will be one-time congestion and edema, which may even cause massive bleeding. Can produce cervical scar, cervical adhesion, affect future fertility and poor tissue penetration, incomplete treatment of deep lesions, high recurrence rate. To sum up, we can see that the traditional treatment methods are not satisfactory, and there are many side effects while treating diseases. At present, the most effective way to treat the disease is to use LEEP knife technology, which can achieve very fine surgical results that traditional electrotome can not achieve. Smooth incision, not easy to leave scars, can make infertile women achieve the purpose of treatment, and preserve the uterus and reproductive function.
Nursing measures
(1) Keep the exterior clean and change underwear frequently. The underwear should be soft and choose pure cotton or silk. (2) During the period of incomplete wound healing (4-8 weeks after operation), bathing, sexual intercourse and vaginal irrigation should be avoided. (3) Postoperative 1 month. Within 2 months, go to the hospital regularly after menstruation is clean to understand the wound healing. (4) Chronic cervicitis has a long course, and patients often lack self-confidence. It is necessary to patiently explain the illness to patients, so that patients can establish confidence and actively cooperate with the treatment.
Special tips
Regular gynecological examination, found that acute cervicitis should be actively treated; Avoid cervical injuries or instruments during delivery; Postpartum cervical laceration should be sutured in time. Pay attention to follow-up to prevent cancer.
Prevention and treatment of chronic cervicitis;
Chronic cervicitis is a chronic gynecological inflammation, which can be divided into fungal and bacterial. Patients should be patient when receiving treatment. They should take medicine strictly according to the doctor's advice under the guidance of a doctor, and don't take medicine without authorization. 1. Two or three days after the treatment of chronic cervicitis, there are more bloody or yellow watery secretions in the vagina. Therefore, cotton sanitary pads can be used during the day, and new pads need to be replaced frequently. You can also wash your vulva with warm water once in the morning and once in the evening. 2. It is best to wear cotton underwear and change it frequently to keep the vulva clean. 3. Sexual intercourse is forbidden for 1-2 months, because after cervical treatment, an inflamed scab will fall off on the surface and new tissues are slowly growing out. In the process of tissue repair, if you have sexual intercourse, the new wound of the cervix will be worn or even bleeding, which will affect the curative effect.