20.9 女性生殖系统紊乱
章节大纲
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Vaccinating Against Cancer
::抗癌疫苗Can a vaccine prevent ? In the case of cervical cancer , it can . Cervical cancer is one of three disorders of the female reproductive system described in detail in this concept. Of the three, only cervical cancer can be prevented with a vaccine.
::疫苗能预防吗?对于宫颈癌,可以预防。宫颈癌是这个概念中详细描述的女性生殖系统三种疾病之一。 在这三种疾病中,只有宫颈癌可以通过疫苗预防。Cervical Cancer
::宫颈癌Cervical cancer occurs when of the cervix (neck of the uterus) grow abnormally and develop the ability to invade nearby tissues or spread to other parts of the body, such as the abdomen or lungs . The figure shows the location of the cervix and the appearance of normal and abnormal cervical cells when examined with a .
::子宫颈癌发生时,子宫颈(子宫颈)异常生长,并发展了侵入附近组织或扩散到身体其他部位(如腹部或肺部)的能力,该图显示了子宫颈的位置以及正常和不正常的子宫颈细胞在接受检查时的外观。Cancer of the cervix — the location of which is shown in the drawings on the left and top right — can be identified by abnormal cervical cells, as shown on the bottom right. CIN stands for cervical intraepithelial neoplasia, which means cancerous cells within the epithelium of the cervix. The designations CIN 1, CIN 2, and CIN 3 refer to the severity of the abnormal cells, with CIN 1 being the least severe, and CIN 3 being the most severe.
::子宫颈癌(其位置在左上和右侧的图纸中显示)可以通过右下显示的不正常的宫颈细胞来辨别。 CIN代表子宫颈内皮肿瘤,这意味着子宫内皮囊内的癌症细胞。CIN 1、CIN 2和CIN 3指异常细胞的严重程度,CIN 1为最不严重者,CIN 3指最严重者。Cervical Cancer Prevalence and Death Rates
::宫颈癌发病率和死亡率Worldwide, cervical cancer is the second most common type of cancer in females (after breast cancer) and the fourth-most common cause of cancer death in females. In the United States and other high-income nations, the widespread use of cervical cancer screening has detected many cases of precancerous cervical changes and has dramatically reduced rates of cervical cancer deaths. About three-quarters of cervical cancer cases occur in developing countries, where routine screening is less likely because of cost and other factors. Cervical cancer is also the most common cause of cancer death in low-income countries.
::在世界范围内,宫颈癌是女性中第二大常见癌症类型(乳腺癌之后),是女性癌症死亡的第四大常见原因;在美国和其他高收入国家,宫颈癌筛查的广泛使用发现了许多宫颈癌突变病例,并大幅降低了宫颈癌死亡率;宫颈癌病例约有四分之三发生在发展中国家,由于成本和其他因素,常规筛查的可能性较低;子宫颈癌也是低收入国家癌症死亡的最常见原因。Symptoms of Cervical Cancer
::子宫颈癌症状Early in the of cervical cancer, there are typically no symptoms. As the disease progresses, however, symptoms are likely to occur. The symptoms may include abnormal vaginal bleeding, pelvic pain, or pain during sexual intercourse. Unfortunately, by the time symptoms start to occur, cervical cancer has typically progressed to a stage at which treatment is less likely to be successful.
::在宫颈癌早期,通常没有症状,但是,随着疾病的发展,症状很可能出现,症状可能包括阴道异常出血、骨盆疼痛或性交过程中的疼痛。 不幸的是,直到症状开始出现时,宫颈癌通常已经发展到治疗不太可能成功的阶段。Cervical Cancer Causes and Risk Factors
::子宫颈癌原因和风险因素More than 90 percent of cases of cervical cancer are caused at least in part by human papillomavirus (HPV) , which is a sexually transmitted that also causes genital warts . The figure shows how HPV infection can cause cervical cancer by interfering with a normal checkpoint. When HPV is not present, cervical cells containing are not allowed to divide, so the cervix remains healthy. When HPV is present, however, cervical cells with mutations may be allowed to divide, leading to uncontrolled growth of mutated cells and the formation of a tumor .
::90%以上的子宫颈癌病例至少部分是由人体乳头瘤病毒(HPV)引起的,这种病毒是性传染的病毒,也会导致生殖器衰竭。该图显示了HPV感染如何通过干扰正常检查站造成子宫颈癌。当HPV不在场时,不允许包含子宫颈细胞分离,因此宫颈癌保持健康。然而,当HPV出现时,带有突变的子宫颈细胞可以分开,导致突变细胞的无节制生长和肿瘤的形成。The presence of HPV may allow cervical cells with mutations to divide, resulting in the formation of a tumor.
::人体免疫机能丧失综合症的存在可能使带有突变的宫颈细胞分裂,导致肿瘤的形成。Other risk factors for cervical cancer include smoking, a weakened immune system (for example, due to infection), use of birth control pills, becoming sexually activity at a young age, and having many sexual partners. However, these risk factors are less important than HPV infection. Instead, the risk factors are more likely to increase the risk of cervical cancer in females who are already infected with HPV. For example, among HPV-infected women, current and former smokers have roughly two to three times the incidence of cervical cancer as non-smokers. Passive smoking is also associated with an increased risk of cervical cancer, but to a lesser extent.
::宫颈癌的其他风险因素包括吸烟、免疫系统薄弱(例如,由于感染)、使用避孕药、年轻时开始性活动以及有许多性伴侣,但这些风险因素不如感染HPV病毒重要,相反,风险因素更有可能增加已经感染HPV病毒的女性患宫颈癌的风险,例如,在感染HPV病毒的妇女中,目前和以前的吸烟者作为非吸烟者的宫颈癌发病率大约是非吸烟者的2至3倍,被动吸烟也与宫颈癌风险增加有关,但程度较低。Diagnosis of Cervical Cancer
::子宫颈癌诊断Diagnosis of cervical cancer is typically made by looking for microscopic abnormal cervical cells in a smear of cells scraped off the cervix. This is called a Pap smear. If cancerous cells are detected or suspected in the smear, this test is usually followed up with a biopsy to confirm the Pap smear results. Medical imaging (by CT scan or MRI, for example) is also likely to be done to provide more information, such as whether the cancer has spread.
::子宫颈癌的诊断通常是通过在子宫颈切除的细胞涂片中寻找显微镜异常的宫颈细胞来进行,这称为子宫颈涂片,如果检测到或怀疑有癌症细胞涂片,通常会进行生物检查,以确认子宫颈涂片结果,医学成像(例如通过CT扫描或MRI)也有可能提供更多信息,例如癌症是否蔓延。Prevention of Cervical Cancer
::预防子宫颈癌It is now possible to prevent HPV infection with a vaccine. The first HPV vaccine was approved by the U.S. Food and Drug Administration in 2006. The vaccine protects against the strains of HPV that have the greatest risk of causing cervical cancer. It is thought that widespread use of the vaccine will prevent up to 90 percent of cervical cancer cases. Current recommendations are for females to be given the vaccine between the ages of nine and 26. (Boys should be vaccinated against HPV, as well, because the virus may also cause cancer of the penis and certain other male cancers.) The vaccine is effective only if it is given before HPV infection has occurred. Using condoms during sexual intercourse can also help prevent HPV infection and cervical cancer, in addition to preventing and sexually transmitted infections (such as HIV).
::现在有可能通过疫苗预防HPV感染。第一种HPV疫苗于2006年获得美国食品和药品管理局批准。疫苗保护人们免受HPV菌株的感染,这些菌株最有可能造成宫颈癌。认为广泛使用疫苗可以预防90%的宫颈癌病例。目前的建议是给女性9至26岁的人接种HPV疫苗(因为病毒还可能造成阴茎癌和某些其他男性癌症)。只有在HPV感染发生之前提供,疫苗才会有效。在性交期间使用避孕套也有助于预防HPV感染和宫颈癌,此外还可以预防性传播感染(如艾滋病毒)。Even in women who have received the HPV vaccine, there is still a small risk of developing cervical cancer. Therefore, it is recommended that women continue to be examined with regular Pap smears.
::即使在接受过HPV疫苗的妇女中,宫颈癌的发病风险仍然很小,因此建议继续定期进行巴氏涂片检查。Treatment of Cervical Cancer
::子宫颈癌治疗Treatment of cervical cancer generally depends on the stage at which the cancer is diagnosed, but it is likely to include some combination of surgery, radiation therapy, and/or chemotherapy . Outcomes of treatment depend largely on how early the cancer is diagnosed and treated. For surgery to cure cervical cancer, the entire tumor must be removed with no cancerous cells found at the margins of the removed tissue on microscopic examination. If cancer is found and treated very early when it is still in the microscopic stage, the five-year survival rate is virtually 100 percent.
::子宫颈癌的治疗一般取决于诊断癌症的阶段,但可能包括某些手术、辐射治疗和/或化疗的结合,治疗的结果主要取决于癌症的诊断和治疗的早期程度,为了治疗宫颈癌,整个肿瘤必须全部除去,在显微镜检查除去组织边缘没有发现任何癌症细胞,如果癌症在微微镜阶段发现和治疗得非常早,则5年存活率几乎为100%。Vaginitis
::阴道炎Vaginitis is inflammation of the vagina — and sometimes the vulva , as well. Symptoms may include a discharge that is yellow, gray, or green; itching; pain; and a burning sensation. There may also be a foul vaginal odor and pain or irritation with sexual intercourse.
::阴道阴道炎,有时还有阴道炎,症状可能包括黄色、灰色或绿色的排泄物、痒痒、疼痛和燃烧的感觉,还可能存在阴道臭味和疼痛,或性交刺激。Causes of Vaginitis
::阴道炎的原因About 90 percent of cases of vaginitis are caused by infection with microorganisms. Most commonly, vaginal infections are caused by the yeast Candida albicans (see figure ). Such infections are referred to as vaginal candidiasis . Other possible causes of vaginal infections include , especially Gardnerella vaginalis , and some single-celled parasites , notably the parasite Trichomonas vaginalis , which is usually transmitted through vaginal intercourse. The risk of vaginal infections may be greater in women who wear tight clothing, are taking antibiotics for another condition, use birth control pills, or have improper hygiene. Poor hygiene allows organisms that are normally present in the stool (such as yeast) to contaminate the vagina.
::大约90%的阴道炎病例是由微生物感染引起的,最常见的是阴道感染是由酵母Candida albicans(见图)引起的,这种感染被称为阴道直肠病,阴道感染的其他可能原因包括,特别是加德罗拉阴道感染,以及一些单细胞寄生虫,特别是寄生虫Trichomeas阴道感染,这种寄生虫通常通过阴道性交传播,穿紧身衣、服用抗生素以取得其他病症、使用避孕药丸或卫生不卫生的妇女,阴道感染的风险可能更大。The yeast Candida albicans — shown here growing on a culture plate — is one of the most common causes of vaginitis.
::Candida albicans酵母——在这里在文化板块上生长——是阴道炎最常见的原因之一。Most of the remaining cases of vaginitis are due to irritation by — or allergic reactions to — various products. These irritants may include condoms, spermicides, soaps, douches, lubricants, and even semen . Using tampons or soaking in hot tubs may be additional causes of this type of vaginitis.
::其余大部分阴道炎病例是由于各种产品刺激或过敏反应造成的,这些刺激剂可能包括避孕套、杀精剂、肥皂、冲洗机、润滑油,甚至精液,使用卫生棉条或浸泡在热水浴缸中可能是造成这种阴道炎的更多原因。Diagnosis of Vaginitis
::阴道炎诊断Diagnosis of vaginitis typically begins with symptoms reported by the patient. This may be followed by a microscopic examination or culture of the vaginal discharge in order to identify the specific cause. The color, consistency, acidity, and other characteristics of the discharge may be predictive of the causative agent. For example, infection with Candida albicans may cause a cottage cheese-like discharge with a low pH, whereas infection with Gardnerella vaginalis may cause a discharge with a fish-like odor and a high pH.
::阴道炎诊断通常从病人报告的症状开始,然后进行显微检查或培养阴道排出物,以确定具体原因,排出物的颜色、一致性、酸性和其他特征可能是致病剂的预测,例如,感染Candida albicans可能导致低pH值的象乳酪一样的小屋排出物,而感染Gardnerella阴道阴道则可能导致类似鱼的气味和高pH值的排出物。Prevention of Vaginitis
::预防阴道炎Prevention of vaginitis includes wearing loose cotton underwear that helps keep the vulva dry. Yeasts and bacteria that may cause vaginitis tend to grow best in a moist environment. It is also important to avoid the use of perfumed soaps, personal hygiene sprays, and douches, all of which may upset the normal pH and bacterial balance in the vagina. To help avoid vaginitis caused by infection with Trichomonas vaginalis , the use of condoms during sexual intercourse is advised.
::预防阴蒂炎包括穿松软的棉内裤,有助于保持阴道干燥;在潮湿的环境中,可能导致阴蒂炎的酵母和细菌往往生长得最好;同样重要的是,要避免使用香皂、个人卫生喷雾剂和冲洗剂,所有这些都可能破坏阴道正常的pH值和细菌平衡;为避免感染Trichomonas阴道而导致的阴道炎,建议性交时使用避孕套。Treatment of Vaginitis
::阴道炎治疗The appropriate treatment of vaginitis depends on the cause. In many cases of vaginitis, there is more than one cause, and all of the causes must be treated to ensure a cure.
::对阴道炎的适当治疗取决于病因,在许多阴道炎病例中,有不止一种原因,所有原因都必须得到治疗,以确保治愈。-
Yeast infections of the vagina are typically treated with topical anti-fungal medications, which are available over the counter. The medications may be in the form of tablets or creams that are inserted into the vagina. Depending on the particular medication used, treatment may involve one, three, or seven days of applications.
::阴道感染的动物一般通过抗风疹药物治疗,药片可在柜台上提供,药片或奶油可以插入阴道,视使用的具体药物而定,治疗可能需要一、三或七天时间。 -
Bacterial infections of the vagina are usually treated with antibiotics. These may be taken orally as pills, or applied topically to the vagina in creams.
::阴道细菌感染通常用抗生素进行治疗,可以口服作为药丸,也可以在奶油中以阴道为主。 -
Trichomonas vaginalis
infections of the vagina are generally treated with a single dose of an oral antibiotic. Sexual partners should be treated at the same time, and intercourse should be avoided for at least a week until both partners have completed treatment and been followed-up by a physician.
::阴道的Trichomonas阴道感染一般以口服抗生素的单剂量治疗,性伴侣应同时治疗,在双方完成治疗并由医生跟踪之前,应至少避免性交一周。
Endometriosis
::内分子硬化Endometriosis is a disease in which endometrial tissue, which normally grows inside the uterus , grows outside it, as shown in the figure . Most often, the endometrial tissue grows around the ovaries , Fallopian tubes , and uterus. In rare instances, the tissue may grow elsewhere in the body. The areas of endometriosis typically bleed each month during the menstrual period, and this often results in inflammation, pain, and scarring. An estimated six to ten percent of women are believed to have endometriosis. It is most common in women during their thirties and forties, and only rarely occurs before menarche or after menopause .
::子宫内组织通常在子宫内生长,但如图所示,在这种疾病中,内分泌组织在子宫外生长。多数情况下,内分泌组织在卵巢、输卵管和子宫周围生长。在极少数情况下,组织可能在身体的其他地方生长。内分泌组织通常在月经期间每个月出血,这往往导致炎症、疼痛和疤痕。据估计,有6-10%的妇女被认为患有内分泌。在妇女三十岁和四十多岁时最常见的是内分泌组织,只有在更年期前或更年期后才会发生。In endometriosis, endometrial tissue may grow outside the uterus and cause health problems such as pain, bleeding, scarring, and infertility.
::在子宫内硬化中,内分泌组织可能在子宫外生长,并引起诸如疼痛、出血、疤痕和不孕症等健康问题。Signs and Symptoms of Endometriosis
::内分子化的征兆和症状The main symptom of endometriosis is pelvic pain, which may range from mild to severe. There appears to be little or no relationship between the amount of endometrial tissue growing outside the uterus and the severity of the pain. For many women with the disease, the pain occurs mainly during menstruation . However, nearly half of those affected have chronic pelvic pain. The pain of endometriosis may be caused by bleeding in the pelvis, which triggers inflammation. Pain can also occur from internal scar tissue that binds internal organs to each other.
::内分泌硬化的主要症状是骨盆疼痛,从轻到重不等,在子宫外生长的内分泌组织数量与疼痛严重程度之间似乎关系不大或根本没有关系,对许多患有这种疾病的妇女来说,疼痛主要发生在月经期间,然而,近一半患者患有慢性骨盆疼痛,内分泌硬化疼痛可能由骨盆出血造成,引发炎症发,内部伤疤组织将内脏器官连接在一起,也会造成疼痛。Another problem often associated with endometriosis is infertility, or the inability to conceive or bear children. Among women with endometriosis, up to half may experience infertility. Infertility can be related to scar formation or to anatomical distortions due to the abnormal endometrial tissue. Other possible symptoms of endometriosis may include diarrhea or constipation, chronic fatigue, nausea and vomiting, headaches, and heavy or irregular menstrual bleeding.
::与内分泌硬化经常相关的另一个问题是不孕症,或无法生育或生育子女;在有内分泌硬化的妇女中,最多一半可能患有不孕症;不孕症可能与疤痕形成有关,也可能与异常内分泌组织造成的解剖扭曲有关;内分泌硬化的其他可能症状可能包括腹泻或便秘、慢性疲劳、恶心和呕吐、头痛以及严重或不正常的月经出血。Causes of Endometriosis
::内分子硬化的原因The causes of endometriosis are not known for certain, but several risk factors have been identified, including a family history of endometriosis. Daughters or sisters of women with endometriosis have about six times the normal risk of developing the disease themselves. It has been suggested that endometriosis results from mutations in several genes . It is likely that endometriosis is multifactorial, involving the interplay of several factors.
::内分泌硬化的原因并不清楚,但已查明了几种风险因素,包括家庭内分泌硬化史,内分泌硬化的妇女的女儿或姐妹有六倍左右的正常疾病发展风险,据指出,内分泌硬化是若干基因突变的结果,内分泌硬化可能是多因,涉及若干因素的相互作用。At the physiological level, the predominant idea for how endometriosis comes about is retrograde menstruation. This happens when some of the endometrial debris from a woman’s menstrual flow exits the uterus through the Fallopian tubes, rather than through the vagina. The debris then attaches itself to the outside of organs in the abdominal cavity, or to the lining of the abdominal cavity itself. Retrograde menstruation, however, does not explain all cases of endometriosis, so other factors are apparently involved. Suggestions include environmental toxins and autoimmune responses.
::在生理层面,对内分泌硬化如何产生的主要想法是逆向经期。这发生在妇女月经流的某些内生残块从子宫通过输卵管穿过子宫,而不是通过阴道。 碎片然后附着在腹腔器官外部或腹腔内衬上。 但是,逆向经并没有解释所有内分泌硬化案例,因此显然还涉及到其他因素。 意见包括环境毒素和自动免疫反应。Diagnosis of Endometriosis
::子宫内硬化诊断Diagnosis of endometriosis is usually based on self-reported symptoms and a physical examination by a doctor, often combined with medical imaging, such as ultrasonography. The only way to definitively diagnose endometriosis, however, is through visual inspection of the endometrial tissue. This can be done with a surgical procedure called laparoscopy, illustrated , in which a tiny camera is inserted into the abdomen through a small incision. The camera allows the physician to visually inspect the area where endometrial tissue is suspected.
::内分泌硬化诊断通常基于自我报告的症状和医生的体检,往往与超声波学等医疗成像相结合;然而,确切诊断内分泌硬化的唯一办法是对内分泌组织进行直观检查,这可以通过称为腹腔镜检查的外科手术进行,通过小切口将一台小照相机插入腹部,使医生能够对内分泌组织被怀疑的地区进行视觉检查。Visually inspecting the abdomen for endometrial growths is the most reliable way to diagnose endometriosis.
::视觉检查腹部以观察腹部生长是诊断腹部硬化的最可靠方法。Treatment of Endometriosis
::内分泌硬化治疗The most common treatments for endometriosis are medications to control the pain, and surgery to remove the abnormal tissue. Frequently used pain medications are non-steroidal inflammatory drugs (NSAIDS), such as naproxen. Opiates may be used in cases of severe pain. Laparoscopy can be used to surgically treat endometriosis, as well as to diagnose the condition. In this type of surgery, an additional small incision is made to insert instruments that the surgeon can manipulate externally in order to burn (cauterize) or cut away the endometrial growths. In younger women who want to have children, surgery is conservative to keep the reproductive organs intact and functional. However, with conservative surgery, endometriosis recurs in 20 to 40 percent of cases within five years of the surgery. In older women who have completed childbearing, hysterectomy may be undertaken to remove all or part of the internal reproductive organs. This is the only procedure that is likely to cure endometriosis and prevent relapses.
::对内分泌硬化的最常见治疗是控制疼痛的药物和手术以除去异常组织。经常使用的止痛药物是非小类炎药(NSAIDs),如环丙酮。在严重疼痛的情况下,可以使用阿片类药物。拉帕罗氏菌检查可用于外科治疗内分泌硬化,以及诊断病情。在这种外科手术中,又做了一个小切片,插入外科医生可以外部操作的仪器,以便烧伤(子宫化)或切除宫内生长。在想要孩子的年轻妇女中,手术是保守保守的,以保持生殖器官的完整和功能。然而,在保守的外科手术中,宫内硬化在五年内,20-40%的病例会复发。在已生育的老年妇女中,可以进行子宫内切除所有或部分生殖器官。这是唯一可能治愈内分泌和避免复发病的程序。Feature: My Human Body
::特质:我的人体A Pap smear is a method of cervical cancer screening used to detect potentially pre-cancerous and cancerous cells in the cervix. It is the most widely used screening test for this type of cancer, and it is very effective. The test may also detect vaginal infections and abnormal endometrial cells, but it is not designed for these purposes.
::子宫颈抹片是一种子宫颈癌筛查方法,用于检测子宫颈癌中潜在的先发性细胞和癌症细胞,是对这类癌症最广泛使用的筛查方法,非常有效,也可以检测阴道感染和异常内脏细胞,但并非为此目的设计的。If you are a sexually active female, you should start receiving routine Pap smears by age 21. Because most cases of cervical cancer are caused by infection with human papillomavirus (HPV), which is a sexually transmitted infection , there is little or no benefit to screening people who have not had sexual contact. Starting at age 21, general guidelines are for Pap smears to be repeated every three years until age 50, and then every five years until age 65. Screening may be discontinued after age 65 if the last three Pap smears were normal. If a woman has a complete hysterectomy so she no longer has a cervix, there is also no need for further Pap smears. On the other hand, if a woman has had a history of abnormal Pap smears or cancer, she will likely be screened more frequently. Pap smears can be done safely during the first several months of pregnancy, and resumed about three months after childbirth. Generally, better results are obtained if Pap smears are not done during menstruation.
::如果您是性活跃的女性,则应在21岁之前开始接受常规的子宫颈癌涂片检查。由于宫颈癌的多数病例是人体乳头瘤病毒(HPV)感染造成的,这是一种性传染感染,因此对没有性接触的人进行筛查几乎没有好处或根本没有好处。从21岁开始,一般准则规定Pap涂片检查每三年重复一次,直到50岁,然后每5年重复一次,直到65岁。如果最后3个子宫颈涂片是正常的,在65岁以后,检查可以停止。如果妇女患有完全的子宫颈切除术,因此不再有子宫颈癌,那么也没有必要再进行子宫颈抹片检查。另一方面,如果妇女有非正常的子宫颈抹片检查或癌症史,则可能更经常地进行筛查。在怀孕的头几个月内可以安全地进行Pap涂片检查,并在分娩后大约三个月内恢复检查。一般来说,如果在月内没有进行Pap涂片涂片检查,结果会更好。If you’ve never had a Pap smear, knowing what to expect may help prepare you for the procedure. The patient lies on the examining table with her feet in “stirrups” to hold the legs up and apart. An instrument called a speculum is inserted into the vagina to hold back the vaginal walls and give access to the cervix. A tiny amount of tissue is brushed off the cervix and smeared onto a microscope slide. The speculum is then removed, and the procedure is over. The slide is later examined under a microscope for abnormal cells. Some women experience light spotting or mild diarrhea after a Pap smear, but most have no lasting effects.
::如果你从未做过子宫颈抹片检查,知道什么可以帮助你做好手术的准备。病人躺在检查桌上,用她的脚脚把腿抬起来和分开。一个叫孔孔的仪器被插入阴道内,以挡住阴道墙,并进入宫颈。一小撮组织被从宫颈上擦掉,涂在显微镜幻灯片上。然后,切片被切除,手术结束。后来,在显微镜下对异常细胞进行显微镜检查。有些女性在子宫涂片后经历轻光或轻度腹泻,但大多数都没有持久的效果。Pap smears are uncomfortable and may be somewhat painful for some women. If you experience pain during a Pap smear, tell your health care provider. Many steps can be taken to minimize the pain, which might include using a smaller speculum, using warm instruments and a lubricant, and applying a topical anesthetic such as lidocaine to the cervix before obtaining the smear. Any pain is generally very brief, and the potential reward is worth it. Pap tests are estimated to reduce up to 80 percent of cervical cancer deaths. One of the lives saved could be your own.
::子宫颈涂片有些不舒服,对有些妇女来说可能有些痛苦。如果你在子宫颈涂片期间经历疼痛,请告诉保健提供者。可以采取许多步骤来尽量减少疼痛,这可以包括使用更小的显微镜,使用温暖的仪器和润滑剂,在获得涂片前对子宫颈进行热量麻醉,如利多卡因。任何疼痛一般都非常短暂,而且可能得到的奖励值得。估计子宫颈癌死亡的80%将减少。拯救的生命之一可能是你自己的生命。Summary
::摘要-
Cervical cancer occurs when cells of the cervix grow abnormally and develop the ability to invade nearby tissues or spread to other parts of the body. Worldwide, cervical cancer is the second-most common type of cancer in females and the fourth-most common cause of cancer death in females. Early on, cervical cancer often has no symptoms. Later, symptoms (such as abnormal vaginal bleeding and pain) are likely.
::当子宫颈癌细胞异常生长并发展出侵入附近组织或传播到身体其他部位的能力时,就会产生子宫颈癌,在全世界,宫颈癌是女性中第二常见的癌症类型,也是女性中第四常见的癌症死亡原因,早期宫颈癌通常没有症状,随后,症状(如阴道异常出血和疼痛)很可能出现。 -
Most cases of cervical cancer occur because of infection with human papillomavirus (HPV), so the HPV vaccine is expected to greatly reduce the incidence of the disease. Other risk factors include smoking and a weakened immune system. A Pap smear can diagnose cervical cancer at an early stage. Where Pap smears are done routinely, cervical cancer death rates have fallen dramatically. Treatment of cervical cancer generally includes surgery, which may be followed by radiation therapy or chemotherapy.
::宫颈癌的多数病例是人体乳头瘤病毒(HPV)感染造成的,因此,HPV疫苗预计会大大降低该疾病的发病率,其他风险因素包括吸烟和免疫系统衰弱,Pap涂片可以早期诊断宫颈癌,在定期进行Pap涂片时,宫颈癌死亡率急剧下降,宫颈癌的治疗通常包括外科手术,随后可能进行辐射治疗或化疗。 -
Vaginitis is inflammation of the vagina. A discharge is likely, and there may be itching and pain. About 90 percent of cases of vaginitis are caused by infection with microorganisms, typically by the yeast
Candida albicans
. A minority of cases are caused by irritants or allergens in soaps, spermicides, or douches.
::阴道炎是阴道炎,可能出现排泄物,可能会有痒痒和疼痛,大约90%的阴道炎病例是由微生物感染引起的,主要是由酵母Candida albicans感染,少数病例是由肥皂、杀精剂或吸精剂中的刺激性或过敏性引起的。 -
Diagnosis of vaginitis may be based on characteristics of the discharge, which can be examined microscopically or cultured. Treatment of vaginitis depends on the cause and is usually an oral or topical anti-fungal or antibiotic medication.
::对阴道炎的诊断可能基于排泄的特征,可以进行微观检查或培养,对阴道炎的治疗取决于病因,通常是一种口服或局部抗风素或抗生素药物。 -
Endometriosis is a disease in which endometrial tissue grows outside the uterus. This tissue may bleed during the menstrual period and cause inflammation, pain, and scarring. The main symptom of endometriosis is pelvic pain, which may be severe. Endometriosis may also lead to infertility.
::内分泌硬化是一种在子宫外生长的内分泌组织疾病,这种组织可能在月经期间出血,造成炎症、疼痛和疤痕。 内分泌硬化的主要症状是骨盆疼痛,可能很严重。 内分泌硬化还可能导致不孕症。 -
Endometriosis is thought to have multiple causes, including genetic mutations. Retrograde menstruation may be the immediate cause of endometrial tissue escaping the uterus and entering the pelvic cavity. Endometriosis is usually treated with surgery to remove the abnormal tissue and medication for pain. If surgery is more conservative than hysterectomy, endometriosis may recur.
::内分泌硬化被认为有多种原因,包括遗传突变。内分泌性月经可能是内分泌组织逃离子宫进入腹腔的直接原因。内分泌硬化通常通过手术进行治疗,以除去异常组织和止痛药物。如果外科手术比子宫切除术更保守,内分泌硬化可能会再度发生。
Review
::回顾1. What is cervical cancer? Worldwide, how prevalent is it, and how does it rank as a cause of cancer deaths?
::1. 宫颈癌是什么?全球范围,其流行程度如何,如何被列为癌症死亡的原因?2. Identify symptoms of cervical cancer.
::2. 查明子宫颈癌的症状。3. What are causes of — and risk factors for — cervical cancer?
::3. 宫颈癌的原因和风险因素是什么?4. What roles can Pap smears and HPV vaccines play in preventing cervical cancer cases and cervical cancer deaths?
::4. 在预防宫颈癌病例和宫颈癌死亡方面,巴氏涂片和HPV疫苗可以发挥什么作用?5. How is cervical cancer treated?
::5. 宫颈癌如何治疗?6. Define vaginitis and identify its symptoms.
::6. 界定阴道炎并查明其症状。7. What are some of the causes of vaginitis? Which cause is responsible for most of the cases?
::7. 阴道炎的部分原因是什么?哪种原因造成大多数病例?8. How is vaginitis diagnosed and treated?
::8. 如何诊断和治疗阴道炎?9. What is endometriosis, and what are its symptoms?
::9. 什么是内分泌硬化,其症状是什么?10. Discuss possible causes of endometriosis.
::10. 讨论内分泌硬化的可能原因。11. How is endometriosis treated? Which treatment is most likely to prevent recurrence of the disorder?
::11. 如何治疗内分泌硬化?哪一种治疗最有可能防止疾病复发?12. Which disorder below is the most likely to cause symptoms, specifically during menstruation?
::12. 下面哪一种疾病最容易造成症状,特别是在月经期间?a. endometriosis
::a. 子宫内硬化b. cervical cancer
::b. 子宫颈癌c. HPV infection
::c. 高PV感染d. vaginitis
::d. 阴道炎13. True or False: Yeast infections are normally treated with antibiotics.
::13. 真实或假的:受感染者通常使用抗生素治疗。14. True or False: In the absence of HPV, there are no mutated cells in the cervix.
::14. 真实或假的:在没有HPV的情况下,宫颈中没有变异细胞。15. In the case of infection with Trichomonas vaginalis , why is the woman’s sexual partner usually treated at the same time?
::15. 在感染Trichomeas阴道阴道感染的情况下,为什么通常同时治疗妇女的性伴侣?Explore More
::探索更多Check out this video to learn about fibroids:
::校对:PortnoyOvarian cancer has often been called the "silent killer" because by the time it is discovered, it is often in advanced stages. Learn more here:
::Ovarian癌症通常被称为“静脉杀手”,因为一旦发现,它往往处于高级阶段。 -
Yeast infections of the vagina are typically treated with topical anti-fungal medications, which are available over the counter. The medications may be in the form of tablets or creams that are inserted into the vagina. Depending on the particular medication used, treatment may involve one, three, or seven days of applications.
