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骨盆腔發炎

骨盆腔發炎
圖中繪出的是骨盆腔發炎常發生的位置
类型女性生殖器畸形[*]、adnexal disease[*]、傳染病、疾病
分类和外部资源
醫學專科婦科學
ICD-11GA05
ICD-10N70 -N77
ICD-9-CM614-616
DiseasesDB9748
MedlinePlus000888
eMedicineemerg/410
MeSHD000292
[编辑此条目的维基数据]

骨盆腔發炎（Pelvic inflammatory disease，PID）也稱為盆腔炎，指的是女性子宮或輸卵管受到感染的情形，有些定義也包含卵巢感染[1]。骨盆腔發炎時常無明顯的症狀[2]可能病徵有下腹痛、陰道分泌物、發燒、排尿時尿道有灼熱感、性交疼痛和不規律的流血[1][2]。骨盆腔發炎會導致長期的併發症，例如：不孕症、異位妊娠和慢性骨盆疼痛（英语：chronic pelvic pain）[1]。

大約75~90%的病例可以在感染處發現淋球菌或砂眼披衣菌，但時常有其他不同種細菌同時感染[1]。如果淋病和披衣菌感染的患者未積極接受治療，大約分別有40%和10%會惡化為骨盆腔發炎[1][3]。該疾病危險因子通常和性病相似，包括大量的性伴侶和藥物濫用。陰道灌洗（英语：Vaginal douching）也會增加罹病風險。典型的診斷是基於目前的徵兆和症狀，因此若育齡婦女有下腹疼痛，需將骨盆腔發炎列入可能疾病。直接的診斷是藉由手術中觀看輸卵管和膿。超音波也對診斷很有幫助[1]。

預防方法包含：禁慾、減少性伴侶，以及正確使用保險套[4]。對於具有披衣菌感染風險的女性進行預防性篩檢和治療，也能降低骨盆腔發炎的機會[5]。骨盆腔發炎一旦確診一般建議進行治療[1] ，且性伴侶也需同時進行相關的檢查及治療[5]。症狀輕微者可以注射一劑頭孢曲松抗生素後，口服兩周的多西環素或甲硝唑。重症者如果三天後未改善則需考慮靜脈注射抗生素[6]。

2008年全球有1.06億人感染衣原菌，另外有1.06億人感染淋病[3]，但骨盆腔發炎的人數並不清楚[7]，估計每年約有1.5%的年輕女性有骨盆腔發炎的症狀[7]，美國估計每年有一百人受到骨盆腔發炎的影響[8]。1970年代一種稱為達康盾（英语：Dalkon Shield）的子宮環會增加骨盆腔發炎的機率，現在使用的子宮環在使用一個月之後，不會造成骨盆腔發炎[1]。

參考資料

  1. ^ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Mitchell, C; Prabhu, M. Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment.. Infectious disease clinics of North America. December 2013, 27 (4): 793–809. PMID 24275271. 
  2. ^ 2.0 2.1 Pelvic Inflammatory Disease (PID) Clinical Manifestations and Sequelae. cdc.gov. October 2014 [21 February 2015]. （原始内容存档于2015-02-22）. 
  3. ^ 3.0 3.1 World Health Organization. Global incidence and prevalence of selected curable sexually transmitted infections - 2008 (PDF). who.int: 2, 19. 2012 [22 February 2015]. （原始内容存档 (PDF)于2015-03-19）. 
  4. ^ Pelvic Inflammatory Disease (PID) Patient Counseling and Education. cdc.gov. October 2014 [21 February 2015]. （原始内容存档于2015-02-22）. 
  5. ^ 5.0 5.1 Pelvic Inflammatory Disease (PID) Partner Management and Public Health Measures. cdc.gov. October 2014 [21 February 2015]. （原始内容存档于2017-09-11）. 
  6. ^ 2010 STD Treatment Guidelines Pelvic Inflammatory Disease. cdc.gov. August 15, 2014 [22 February 2015]. （原始内容存档于2015-02-22）. 
  7. ^ 7.0 7.1 Eschenbach, D. Acute Pelvic Inflammatory Disease. Glob. libr. women's med. 2008. ISSN 1756-2228. doi:10.3843/GLOWM.10029. 
  8. ^ Self-Study STD Modules for Clinicians - Pelvic Inflammatory Disease (PID) Next Centers for Disease Control and Prevention Your Online Source for Credible Health Information CDC Home Footer Separator Rectangle Epidemiology. cdc.gov. October 2014 [21 February 2015]. （原始内容存档于2017-09-11）. 

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