浙江大学医学院-妇产科学-课程教案

浙江大学医学院妇产科学课程教案课程名称妇产科学教师及职称林俊教授授课内容女性生殖系统炎症及性传播疾病子宫肌瘤子宫内膜异位疾病学时3学时授课方式理论课授课学期2007-2008第二学期授课对象04级临床医学教学目的（教学大纲要求）掌握：子宫肌瘤类型、病理、临床表现、诊断处理；子宫内膜异位症：的病理、临床表现、诊断及治疗。熟悉：常见阴道炎病原、传播途径、临床表现、诊疗原则；慢性宫颈炎的病理变化、临床表现、综合治疗；常见性传播疾病的传播途径、临表、诊疗、治愈标准。了解：女性生殖系统自然防御机制、阴道正常菌群及影响生态平衡的因素。性传播疾病概念、预防；子宫内膜异位症病因。教学内容及时间分配（双语教学用*注明）1.外阴及阴道炎症：滴虫阴道炎(TrichomonalVaginitis)、假丝酵母菌外阴阴道炎(CandidalAlbicans)、细菌性阴道病(BacterialVaginosis)的传播途径、临床表现、诊治；2.性传播性疾病：传播途径、临床表现、治疗；3.盆腔炎：病理、临床表现、诊断、治疗；4.*子宫肌瘤（myomaofuterus）：发病相关因素、分类、病理、肌瘤变性、临床表现、诊断及处理；5.子宫内膜异位症(endometriosis,EMT)：好发部位、病因、病理、临床表现、诊断及治疗；25min15min20min20min40min重点1慢性宫颈炎：病理分型2子宫肌瘤：类型、病理、肌瘤变性、手术与非手术治疗；3子宫内膜异位症：病理、临床表现、诊断及治疗。教学重点与难点难点子宫内膜异位症病因学的理解教学方法多媒体教学+双语专业词汇要求（Trichomonal、Candidal、Bacterial）Vaginitis、cervicitis、cervicalerosion、cervicalpolyp、Nabothcyst、cervicalhypertrophy、Pelvicinflammatory-PID、（sexuallytransmitteddisease)STD、gonorrhea、syphilis、condylomaacuminata、（intramural、subserous、submucous）myoma、endometriosis、adenomyosis教具准备PowerPoint课件复习思考题1.试述各类阴道炎临床表现的区别及慢性宫颈炎的各型病理；2.试述子宫肌瘤的分类及各肌瘤瘤变类型；3.试述子宫内膜异位症典型症状及个体化治疗。要求自学内容各类外阴炎，各阴道炎的发病机制，老年性阴道炎，婴幼儿外阴阴道炎，生殖器结核，急性宫颈炎，生殖器沙眼衣原体感染，生殖器疱疹，HIV，子宫肌瘤鉴别诊断，子宫内膜异位症病因及预后、子宫腺肌病教材及参考书1.妇产科学（丰有吉主编，七年制规划教材）2.中华妇产科学（曹泽毅主编，第二版）教学网站网址(PH4.5,3.84.4)pHTrichomonalVaginitispH5(56.5)CandidalAlbicanspH4.5(4.04.7)BacterialVaginosis¡ªpH-++1%0.5%2%-4%.Cervicitis(ChronicCervicitis)1.(cervicalerosion)----().:(I)1/3(II)1/3~2/3(III)2/32.(cervicalpolyp)3.(endocervicitis)4.Nabothcyst5.cervicalhypertrophy.---():LEEP——.(Pelvicinflammatory-PID)1.2.3.PH4.5,3.84.44.5.6.1..2.IUD.3.4.(AcuteSalpingitis-Peritionitis)1.2.(tubo-ovarianabscessTOA)3.4.5.6.Fitz-Hugh-Curtis1.2.,1.2.3.1.38()2.10109/L3.4.5.B6.1.2.31.2.++++G-3.4.(ChronicPelvicInfection)1.2.3.4.1.2.3.(sexuallytransmitteddisease)STD()STDgonorrhea50%~70%1.2.3.4.++——PCR----——24~7-syphilis------1.--2~82.100%3.1.2.—VDRLUSRRPR—TPHAFTAABS3.(condylomaacuminata)(HPV)+PCRHPV(myomaofuterus).(GeneralConsiderations):,,(leiomyomaofuterus).,30-50,40-5020:30%.(Pathogenesis)1.(E2)(ER),2.3..(classification):(90%)(10%)1.intramuralmyoma60%-70%;2.subserousmyoma20%-,3.submucousmyoma10%-15%.(leiomyomaspathology):,,;,:;.(sencondarychanges)hyalinedegenerationcysticdegenerationreddegeneration,,.sarcomatousdegeneration,,,:(Myxomatous),(Calcific),(Infection).(ClinicalFindings):1.(abnormaluterinebleeding):2.(abdominalmass):,,3.(pressureeffects):,;,4.:,,(anemia),(infertility),(abortion):(subserousandintramuralmyoma),(submucousmyoma),().(diagnosisanddifferentialdiagnosis):,B1.2.3.4.5.:.(treatment).,,;3-6.2,1.danazol300mg2.GnRHaFSHLH——3.10;;;.(GeneralConsiderations),(endometriosis,EMT)adenomyosis“”(womeninreproductiveage)70,15.(Pathogenesis)1921Sampson.(Pathology)1.2.:,,,3.:----4..(ClinicalFindings)1.(Pelvicpain).2.(Infertility)EM30-40%(LUPS).3.(Menoxenia)4.(Dyspareunia)5.6.Bloodyinurineorstooletal.(retroverteduterine)(fixed)(tendernodules),.(diagnosisanddifferentialdiagnosis)(Laparoscopy):B,CA125,200U/ml()AFS.treatment1.(observation)2.(Chemotherapy)/3cm(pseudomenopause)GnRH-aGnRHFSH.3(pseudopregnancy)3.(surgicaltreatmen):+Conservativesurgery45(difinitivesurgery)4.+++3-6.(result)highreoccurence1.2.3.2006.3.1