盆腔瘀血综合征

盆腔瘀血综合征的临床表现

盆腔瘀血综合征几乎半数以上患者有此症状:月经前数天即开始出现下腹痛、腰骶部痛或盆腔内坠胀痛,有的还逐渐转为痉挛性疼痛,到月经来的前一天或第一天最厉害,月经第二天以后明显减轻。

一、下腹部疼痛

多数为慢性耳骨联合上区弥漫性疼痛,或为两侧下腹部疼痛,常常是一侧较重,并同时累及同侧或下肢,尤其是大腿根部或髋部酸痛无力,开始于月经中期。有少数病人偶尔表现为急性发作性腹痛,易误诊为急性阑尾炎、卵泡破裂、异位妊娠破裂。

二、低位腰痛

病人所指的疼痛部位相当于骶臀区域水平,少数在骶骨下半部,常伴有下腹部疼痛症状。经前期、长久站立和***后加重。

三、痛经

几乎半数以上患者有此症状。特点是月经前数天即开始出现下腹痛、腰骶部痛或盆腔内坠胀痛,有的还逐渐转为痉挛性疼痛,到月经来的前一天或第一天最厉害,月经第二天以后明显减轻。

四、性感不快

如问及病人,常诉称做爱时有不同程度的痛感,多为深部做爱痛,有的几乎难以忍受,不但当时疼痛,次日下腹痛、腰痛、白带多等症状都明显加重,因而病人对性生活产生了厌烦。

五、极度疲劳感

病人往往整天感到非常疲劳,几乎无力完成自己所担负的工作(包括家务)。

六、白带过多

一半以上的病人有白带过多的症状。白带的性状多为清晰的粘液,无感染征。

七、月经改变

一部分病人有月经过多的改变,常因其子宫肥大被误诊为子宫肌瘤或子宫肥大症。还有一部分病人月经量反较前减少。但伴有明显的经前期乳房痛。

八、瘀血性乳房痛

以上的病人伴有瘀血性乳房疼痛、肿胀。患者自己能摸到乳房硬结,并有压痛,多于月经中期以后随上述症状同时出现,至月经前一天或月经来潮的第一天达高峰,月经过后,随同上述症状有所减轻,或完全消失。有的病人其乳房疼痛较盆腔疼痛为重,以至成为来诊的主诉。

九、外阴阴道肿胀、坠痛

盆腔瘀血症患者常有外阴和阴道内肿胀、坠痛感,或有外阴烧灼、瘙痒感。外阴可表现着色,阴唇肿胀或肥大,以至某种程度的静脉充盈、怒张或曲张。

十、膀胱和尿道症状

约有1/3以上患者在经前期有明显的尿意频数及排尿痛症状,常被怀疑为泌尿道感染,但尿常规检查正常。对某些症状严重的患者进一步做膀胱镜检查,可发现膀胱三角区静脉充盈、充血和水肿。个别患者由于瘀血的小静脉破裂可导致血尿。

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