盆腔炎性疾病相关女性慢性盆腔痛的诊治现状及思考

李晨笛, 黄立师, 许泓

中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (8) : 793-797.

PDF(913 KB)
PDF(913 KB)
中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (8) : 793-797. DOI: 10.19538/j.fk2025080106
专题笔谈

盆腔炎性疾病相关女性慢性盆腔痛的诊治现状及思考

作者信息 +

Current status and thoughts on the diagnosis and treatment of chronic pelvic pain in women with pelvic inflammatory disease

Author information +
文章历史 +

摘要

盆腔炎性疾病(pelvic inflammatory disease,PID)是指女性上生殖道的一组感染性疾病,主要包括子宫内膜炎、输卵管炎、输卵管卵巢脓肿及盆腔腹膜炎。炎症迁延不愈反复发作,往往导致慢性盆腔痛,严重影响女性的身心健康与生活质量。目前仍缺乏兼备敏感度与特异度的诊断方法及经济有效的治疗方式。文章就PID后慢性盆腔痛的诊治现状作一概述。

Abstract

Pelvic inflammatory disease (PID) refers to a group of infectious diseases affecting the female upper reproductive tract,including endometritis,salpingitis,tubo-ovarian abscess,and pelvic peritonitis. Persistent and recurrent inflammation often leads to chronic pelvic pain,significantly impacting women's physical and mental health as well as their quality of life. Currently,there is still a lack of diagnostic methods that are both sensitive and specific,as well as cost-effective treatment options. This article provides a review of the current status of the diagnosis and treatment of chronic pelvic pain following PID.

关键词

盆腔炎性疾病 / 慢性盆腔痛

Key words

pelvic inflammatory disease / chronic pelvic pain

引用本文

导出引用
李晨笛, 黄立师, 许泓. 盆腔炎性疾病相关女性慢性盆腔痛的诊治现状及思考[J]. 中国实用妇科与产科杂志. 2025, 41(8): 793-797 https://doi.org/10.19538/j.fk2025080106
LI Chen-di, HUANG Li-shi, XU Hong. Current status and thoughts on the diagnosis and treatment of chronic pelvic pain in women with pelvic inflammatory disease[J]. Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(8): 793-797 https://doi.org/10.19538/j.fk2025080106
中图分类号: R711.71   

参考文献

[1]
Brunham RC, Gottlieb SL, Paavonen J. Pelvic inflammatory disease[J]. N Engl J Med, 2015, 372(21):2039-2048. DOI:10.1056/NEJMra1411426.
[2]
Lamvu G, Carrillo J, Ouyang C, et al. Chronic pelvic pain in women:A review[J]. JAMA, 2021, 325(23):2381. DOI:10.1001/jama.2021.2631.
[3]
Ness RB, Soper DE, Holley RL, et al. Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease:Results from the pelvic inflammatory disease evaluation and clinical health (PEACH) randomized trial[J]. Am J Obstet Gynecol, 2002, 186(5):929-937. DOI:10.1067/mob.2002.121625.
[4]
Haggerty CL, Gottlieb SL, Taylor BD, et al. Risk of sequelae after chlamydia trachomatis genital infection in women[J]. J Infect Dis, 2010, 201(Suppl 2):S134-S155. DOI:10.1086/652395.
[5]
冯旸子, 范琳媛, 刘朝晖. 青少年盆腔炎性疾病的易感因素及治疗[J]. 中国实用妇科与产科杂志, 2023, 39(3):380-382. DOI:10.19538/j.fk2023030126.
[6]
秦君璞, 张帝开. 盆腔炎性疾病与盆腔痛[J]. 中国实用妇科与产科杂志, 2013, 29(3):170-173.
[7]
贺豪杰, 陈娟, 侯征, 等. 女性慢性盆腔痛诊治中国专家共识[J]. 中华妇产科杂志, 2024, 59(10):747-756. DOI:10.3760/cma.j.cn112141-20240320-00171.
[8]
杨慧霞, 狄文, 朱兰. 妇产科学[M]. 2 版. 北京: 人民卫生出版社, 2021.
[9]
Jarrell JF, Vilos GA, Allaire C, et al. No. 164-consensus guidelines for the management of chronic pelvic pain[J]. J Obstet Gynaecol Canada, 2018, 40(11):e747-e787. DOI:10.1016/j.jogc.2018.08.015.
[10]
Bartlett EC, Levison WB, Munday PE. Pelvic inflammatory disease[J]. BMJ, 2013, 346:f3189. DOI:10.1136/bmj.f3189.
[11]
Khan KS, Tryposkiadis K, Tirlapur SA, et al. MRI versus laparoscopy to diagnose the main causes of chronic pelvic pain in women:A test-accuracy study and economic evaluation[J]. Health Technol Assess, 2018, 22(40):1-92. DOI:10.3310/hta22400.
[12]
Shibuki S, Saida T, Hoshiai S, et al. Imaging findings in inflammatory disease of the genital organs[J]. Jpn J Radiol, 2024, 42(4):331-346. DOI:10.1007/s11604-023-01518-8.
This review focuses on inflammatory diseases of female and male genital organs and discusses their epidemiology, pathogenesis, clinical presentation, and imaging findings. The female section covers pelvic inflammatory disease (PID) primarily caused by sexually transmitted infections (STIs) that affect the uterus, fallopian tubes, and ovaries. Unusual causes such as actinomycosis and tuberculosis have also been explored. The male section delves into infections affecting the vas deferens, epididymis, testes, prostate, and seminal vesicles. Uncommon causes such as tuberculosis, and Zinner syndrome have also been discussed. In addition, this review highlights other conditions that mimic male genital tract infections such as vasculitis, IgG4-related diseases, and sarcoidosis. Accurate diagnosis and appropriate management of these inflammatory diseases are essential for preventing serious complications and infertility. Imaging modalities such as ultrasound, magnetic resonance imaging, and computed tomography play a crucial role in diagnosis. Understanding the diverse etiologies and imaging findings is vital for the effective management of inflammatory diseases of the genital organs.© 2023. The Author(s).
[13]
中华医学会妇产科学分会感染性疾病协作组. 盆腔炎症性疾病诊治规范(2019修订版)[J]. 中华妇产科杂志, 2019, 54(7):433-437. DOI:10.3760/cma.j.issn.0529-567x.2019.07.001.
[14]
Till SR, Nakamura R, Schrepf A, et al. Approach to diagnosis and management of chronic pelvic pain in women:Incorporating chronic overlapping pain conditions in assessment and management[J]. Obstet Gynecol Clin North Am, 2022, 49(2):219-239. DOI:10.1016/j.ogc.2022.02.006.
[15]
Ye H, Tian Y, Yu X, et al. Association between pelvic inflammatory disease and risk of endometriosis:A systematic review and meta-analysis[J]. J Women’s Health (Larchmt), 2024, 33(1):73-79. DOI:10.1089/jwh.2023.0300.
[16]
Hu P, Gao Y, Zhang Y, et al. Ultrasound image-based deep learning to differentiate tubal-ovarian abscess from ovarian endometriosis cyst[J]. Front Physiol, 2023, 14:1101810. DOI:10.3389/fphys.2023.1101810.
Objectives: We developed ultrasound (US) image-based convolutional neural networks (CNNs) to distinguish between tubal-ovarian abscess (TOA) and ovarian endometriosis cyst (OEC).
[17]
刘艳霞, 刘朝晖, 周德平, 等. 金英胶囊治疗盆腔炎性疾病(湿热蕴结证)的随机、双盲双模拟、阳性药平行对照、多中心临床研究[J]. 中国实用妇科与产科杂志, 2020, 36(2):163-167.DOI:10.19538/j.fk2020020117.
[18]
Teng X, Li H, Yang D, et al. ZY5301 tablet vs placebo for treatment of chronic pelvic pain after pelvic inflammatory disease:A phase 2 randomized clinical trial[J]. JAMA Netw Open, 2024, 7(7):e2423229. DOI:10.1001/jamanetworkopen.2024.23229.
Chronic pelvic pain (CPP) is the main sequela of pelvic inflammatory disease (PID), with no established treatment. ZY5301 tablets, an effective part preparation extracted from Ajuga decumbens Thunb. (jingucao), are being tested as a treatment for CPP caused by PID.
[19]
van den Beukel BA, de Ree R, van Leuven S, et al. Surgical treatment of adhesion-related chronic abdominal and pelvic pain after gynaecological and general surgery:A systematic review and meta-analysis[J]. Hum Reprod Update, 2017, 23(3):276-288. DOI:10.1093/humupd/dmx004.
[20]
刘颖华, 王昕, 梁卓, 等. 针刺联合西药治疗盆腔炎性疾病后遗症慢性盆腔痛:多中心随机对照研究[J]. 中国针灸, 2021, 41(1):31-35. DOI:10.13703/j.0255-2930.20191218-k0002.
[21]
Du J, Fang J, Wen C, et al. The effect of electroacupuncture on PKMzeta in the ACC in regulating anxiety-like behaviors in rats experiencing chronic inflammatory pain[J]. Neural Plast, 2017,2017:3728752. DOI:10.1155/2017/3728752.
[22]
袁静雪, 刘志顺. 针灸治疗盆腔炎性疾病后遗症慢性盆腔痛诊疗特点的文献分析[J]. 中华中医药杂志, 2019, 34(3):1236-1240.
[23]
刘淑珍. 中药熏蒸疗法治疗慢性盆腔炎疗效观察与护理体会[J]. 光明中医, 2018, 33(12):1812-1814.
[24]
赵亚, 郭梦娇, 许婵娟, 等. 中药热敷联合穴位按摩在气滞血瘀证盆腔炎性疾病后遗症中的应用效果[J]. 中国医药导报, 2022, 19(4):132-135,148. DOI:10.20047/j.issn1673-7210.2022.04.026.
[25]
李洁, 张媛, 张俊勤, 等. 经皮神经电刺激联合布洛芬缓释胶囊对盆腔炎性疾病所致慢性盆腔疼痛患者血清炎症因子和致痛物质水平的影响[J]. 现代生物医学进展, 2023, 23(1):197-200,192. DOI:10.13241/j.cnki.pmb.2023.01.039.

基金

上海交通大学“交大之星”计划医工交叉研究基金重点项目(YG2025LC11)

PDF(913 KB)

Accesses

Citation

Detail

段落导航
相关文章

/