(5) of endometrial cancer: irregular uterine bleeding, in less time for a long time, the official endoscopic examination and diagnostic curettage can be confirmed.
(6) systemic diseases: If blood disease, liver disease and thyroid disease can also be associated with irregular vaginal bleeding, asked about the history, physical examination and laboratory tests can be confirmed.
[Treatment]
1. Western medicine treatment
(1) to stop bleeding
① progesterone drugs: progesterone 20 mg / day, intramuscular injection three days, the Palace progesterone 8-16 mg / day, UNIFEM Tablet 4-8 mg / day or UNIFEM Tablet 2.5-5. Omg /, a total of five days, oral. Amenorrhea than the long, thick endometrium, and also used testosterone propionate one, the young are 25 mg / day, the older 50 mg / day, 3-5 days intramuscular injection. Applies to more than six grams hemoglobin and blood work with menopause.
② estrogen formulations: diethylstilbestrol 2 mg, every hour, 6-8, blood only three days after decreasing 1 / 3 volume, volume of O. 5mg / day, only after the blood to 20 days. Or estradiol benzoate 2 n Meng, an intramuscular injection every 6-8 hours, and decreasing law ibid., blood only after the switch to oral diethylstilbestrol. Applicable to acute bleeding and anemia significantly adolescent patients with blood work.
③ other bleeding drugs: Tongxinluo such as the blood-bleeding, bleeding-acid, vitamin K, such as, but not effective, it’s only as a supplementary measure to stop bleeding.
(1) adjusting the menstrual cycle (blood only after the application).
① cycle of treatment (see the lean period).
② estrogen and progesterone combination therapy: general use of oral contraceptives, Fufa with contraception, applicable to the requirements of child-bearing age are without birth.
③ progesterone treatment: bleeding before the next 1-2 days or Jianxue after intramuscular progesterone 20 mg / day, a total of three days, or the Palace of oral progesterone, Mount films such as UNIFEM. Gong for menopause blood, the linked three cycles.
(3) restore ovulation function, the treatment of adolescent fertility and ovulation period of five blood work and the fundamental measures.
① Keluo Mi phenol (see frequent menstruation).
② tamoxifen (see frequent menstruation).
③ hCG; menstrual cycle in the first 16-18 days, each 5000-10000 IU, the next day muscle Zhu 1, a total of 2 times.
④ gonadotropin-releasing hormone: in the mid-consecutive menstrual pulse administration, the daily 5 mg, a total of three days.
(4)-induced amenorrhea: older women with menopause and methyl-testosterone 5-10 mg / day, or inhibit endometrial gossypol medicines, so that fewer menstrual gradually until menopause.
(5) hysterectomy: for conservative treatment is invalid and without patients with severe birth.

1. Basic life support (BLS)
Airway open airway
⒈ should not use push jaw, chin give way to choose a suitable ventilation Road oropharynx.
⒉ open airway intubation, as far as possible choices.
⒊ intubation from sniffing flowers posture exposed throat. (Do not head and neck hyperextension)
⒋ choose a suitable laryngoscope tablets and tracheal tube.
⒌ neonatal, small Intubation babies should be used catheter movements, <6 to 8-year-old cystic duct-free sets. Suitable calibre in the tracheal tube after intubation IPPV20 ~ 30cmH2O pressure breathing airway when a gas leakage sound. After intubation properly fixed. Endotracheal tube diameter can refer children with the size of the nose or little finger tip choice or formula:
Endotracheal tube diameter (ID) mm = age / 4 +4
Intubation depth (incisors to the end of catheter) cm = diameter catheter number × 3
⒍ apnea suspected jets epiglottic inflammation, the following procedures should be dealt with airway: ① oropharyngeal ventilation Road home after judging whether the location could ventilation satisfaction. ② the use of sufficient pressure (adequate tidal volume) as masks - simple ventilator to IPPV. ③ handling invalid. Intubation; plus catheter movements, optional fine on the 1st of endotracheal tube, after intubation tube location of the correct judgement. ④ handling invalid (not intubation). Crude trocar (14 G) A Central Bank or Central trachea film membrane puncture (cricothyrotomy) followed by simple ventilator IPPV.
Breathing (artificial)
⒈ ventilation frequency: neonatal 20 ~ 30bpm
<1-year-old 20 bpm (respiratory cycle 3 s, I / E 1:2)
1 to 8-year-old 15bpm (respiratory cycle 4 s)
> 8-year-old 12bpm
⒉ tidal volume TV10 ~ 15ml/kg, minute ventilation MV100 ~ 120ml/kg.
⒊ have adequate ventilation when hypoxia will struggle to calm the children or to apnea or to be synchronized with IPPV.
⒋ such as switching capacity in children IPPV election, normal lung compliance, PIP should be up to 20 ~ 25 cmH2O, when the suction of at least 0.6 s, which was too short to suction PIP too high, too low and often prompts TV PIP inadequate. Lung compliance diminish the children, PIP need of 30 cmH2O.
⒌ such as pressure switch mode, PIP requirement Ibid. When the tracheal tube was too deep bronchial-pulmonary ventilation duct or incomplete due to obstruction (secretions or distorting) airway pressure ventilation does not reflect the effect of this addition to SpO2, should also be monitoring ETCO2 or blood gas analysis.
Circulation (Circular)
⒈ pressure in the chest: the children of different ages, physical size respectively Erzhi, referring to three or palm roots push »two babies below the midpoint of the nipple-line, press sternum in children under 1 / 3, the principle of the heart before the district are Pressing enough area to generate maximum pressure on the heart, chest compression before and after the trail takes 25 percent to 50 percent.
⒉ rhythm: newborn 100 ~ 120bpm
Infant 100bpm
Older children 80 ~ 100bpm
Pressing time of the cardiac cycle 30%
⒊ ventilation / chest pressure ratio is 1:5. Only to young single people in recovery to pressure chest: ventilation to 15:2. Chest pressure artificial ventilation should be suspended. In intubation IPPV may not mind matching the two issues.

2. First-aid medication
(1). Pathfinder: veins, bone marrow, within the tracheal tube.
Central vein is the ideal approach, the superior vena cava and the inferior vena cava administration. CPR will be open vein in children is difficult, after the drug’s cardiac massage also effective role in the heart of drug onset.
The bone marrow treatment may also achieve the purpose of quickly and efficiently, particularly for infants and young children. Tibial tuberosity can puncture the bottom or distal femur before or iliac spine. Should pay attention to bone marrow may trigger »fat embolism and pulmonary complications such as fractures.
The endotracheal tube administration of the blood concentration of the same vein approach, several times the dose required to intravenous injection, the pulmonary circulation in the cycle of drug absorption may arise after the resumption of high blood pressure significantly longer time to recovery of the brain and cause adverse myocardial ischemia. Dose of epinephrine 1:1000 0.1mg/kg. Following a 2 ~ 5 ml of water injection or NS washing. Or diluted drugs to 2 ~ 5 ml injection. At the same time to pressure breathing pulmonary circulation to promote absorption.
(B) infusion:
1. If the cycle of arrest, intravenous (or bone marrow) infusion only way to first-aid treatment, the infusion rate to maintain only path open.
2. Infusion optional isotonic sugar-free solution, in accordance with a decision of transfusion with blood sugar or glucose, recommended for use in children or micro-infusion pumps.
(C) recovery after arrhythmia drug treatment:
After the recovery of all arrhythmia secondary to the lack of oxygen, acid poisoning metabolic disorders, should maintain the airway open and endotracheal tube position, improve the oxygenation enhance ventilation.
Antiarrhythmic drug indications and adults the same. At the same time should pay attention to whether the symptoms associated with hypoperfusion (such as peripheral cyanosis, low blood pressure, heart sounds low blunt, the capillaries to extend the filling), should be aware of all ages circulation (blood pressure) to allow the minimum parameters:
Infant SBP ≤ 70 mmHg
Children SBP ≤ (70 + age × 2) mmHg
Newborn blood pressure measurement is difficult, HR <80bpm hemodynamic imbalance can be used as the objective indicators.
Adrenaline in pediatric cardiopulmonary resuscitation in the role:
1. Pediatric cardiac stop is the most optimal drug.
2. Hypoxia ischemia induced bradycardia, in response to the reasons for treatment (to correct the lack of oxygen, lifting Airway obstruction) of the Commission with adrenaline.
3. Bradycardia recovery after the single-adrenergic only temporarily effective, often continuous infusion or injection pumps adrenaline.
4. PEA (pulseless electric activity), ECG machine is the separation of (EMD) of a special type. Characterized by a main artery pulsatility missing, with the QRS wave widened bradycardia. EMD is common in severe low blood volume, QRS wave narrow and fast or normal heart rate, tension pneumothorax and cardiac tamponade will happen when. CPR should be cause for emergency treatment.
5. Ventricular fibrillation: electric defibrillator fails to be added to adrenaline. (3 ~ 5min medication and a successive incremental).
6. Organ recovery after low-flow perfusion. Children almost no coronary lesions caused little concern disorders and heart rate increased myocardial oxygen from the risk of myocardial ischemia.
The first of epinephrine 0.01 mg / kg (0.1ml/kg 1:10000) injection. In the bone marrow can not or intravenous administration, tracheal to 0.1 mg / kg (0.1ml/kg 1:1000), such as the 3 ~ 5 min after the invalid, can be the first of 10 times the volume of delivery.
Sodium bicarbonate not be first-line drugs, when epinephrine, can be used sodium bicarbonate, after intravenous drug pipeline should be washed (NS or 5% GS) so as to keep other drug precipitation. Atropine or calcium did not stop the cardiac benefits of calcium for the treatment of the merger have only hypocalcemia, or hyperkalemia hypermagnesemia (pregnant Duzheng magnesium in the treatment of newborn infants hypermagnesemia ), And calcium channel blockers poisoning.

3. Ventricular fibrillation and with the pulse of the missing ventricular tachycardia treatment
Two cycle arrest in children is rare. Often secondary to metabolic disorders such as hyperkalemia, drug poisoning (digitalis toxicity) and hypothermia (core temperature <33 ℃). Available seconds 2 watts / kg Xiongwai to flutter and rehabilitation law. If defibrillator needed to be invalid by adrenaline. Lidocaine should lose no time in the defibrillator after the success of the use or electricity to flutter in three (2,4,4-Watt seconds / kg) when the application is invalid, 10 ~ 15 min after repeated use.there, and then the frequency of ventricular fibrillation or rooms as early as when the lidocaine should be continuous infusion. At the same time should be cause for emergency room treatment of rhythm.
Children physical size because of age differences, in case of emergency for the time can still be used for adult-board electric shocks, electric shocks on the boards of small babies can be placed in the heart Qian Houbi chest wall to avoid contact with the shock plate, so as to avoid electric shocks short-circuit Prejudicial to the heart.

4. Recovery of stability after the respiratory and circulatory
Octopus-BLS CPR treatment after the resumption of regular breathing and heartbeat have low blood pressure and severe acidosis, often cardiogenic shock, and some children because of aspiration, pulmonary edema or lung disease caused by reduced lung function decreased lung compliance, to ensure that Airway open to improve ventilation and oxygenation, to correct myocardial hypoxia provide an important safeguard. After the recovery of the shortage of organ perfusion pediatric infusion 20 ml / kg after the assessment of their response. Low blood pressure and blood flow to the organs of low perfusion discretion infusion of adrenaline, dopamine and dobutamine, which preferred epinephrine in children. Dose of 0.05 ~ 1.0 ug / kg / min, low blood pressure when the infusion dose can be greater.
Dobutamine indications: jump-normal blood pressure but after the lack of organ perfusion. Should not be used for hypotension. Dose of 5 ~ 20 uk / kg / min.
Dopamine is a strength of the frequency and positive role. Visceral blood flow to the kidney and selective role. Dose 2 ~ 5 ug / kg / min.

5. Broselow recommended emergency resuscitation device for rapid delivery
Children under the first-aid-foot length (cm) to estimate body weight (kg) as shown in the list selected by the various emergency dose, infusion volume, power, to chatter, and intubation depth can increase the speed and accuracy of the recovery response.

6. Termination of recovery
As parents of children with emotional reasons for the termination of recovery often encountered great difficulties. A long time to recover the heart may jump, but it is inevitable failure of the recovery, particularly outside the cycle of arrest in children.
There are two groups of children with recovery invalid reports: Zaritsky 31 recovery of the use of the second dose of epinephrine were not survive. Nichols 21 recovery of the use of more than 2 times the adrenaline and sodium bicarbonate no one case of survival. Children of multiple injuries due to arrive at the emergency department cycle arrest or cardiac arrest, his prognosis is very disappointing.
In the provision of adequate ventilation and oxygenation, effective Xiongwai press, open veins and the 3 ~ 5 min repeated drug epinephrine, and the second dose of the first of 10 times, and to rule out poisoning, hypothermia, children Has not been restored to a stable rhythm infusion could be considered terminated when the recovery. In terms of time on the main artery pulse disappeared due to cardiac arrest and resuscitation invalid by the 15 ~ 20 min above may consider termination of recovery.

In addition, menopausal vaginal bleeding and cancer, but also increase with age, menopause extension of time, menopausal bleeding occurred in the risk of cancer increases. Therefore, should menopausal bleeding as a danger signal, attention, positive -
Take the necessary means of inspection, such as cervical biopsy, diagnosis and curettage, B Chaodeng to facilitate early diagnosis timely treatment and must not clear when the diagnosis did not stop bleeding drug abuse cover up symptoms delayed treatment.

According to clinical analysis, menopause causes of vaginal bleeding, dysfunctional uterine one of them. If the menopause ovarian endocrine function has not been completely stopped, there are still over a longer period of time sex hormone secretion, endometriosis is still a long time by the stimulation of estrogen, which may become endometrial cancer in the potential risk factors. So deal with such patients in particular, obesity, hypertension, diabetes and other factors closely follow-up of patients.

According to pathogenic factors bleeding after menopause are inflammatory, tumor cases, endocrine, and other body parts (trauma, foreign body), five major reasons.

According to bleeding site. Can be divided into vulva, vagina. In the government, the Department of Mao and tubal bleeding.

Bleeding after menopause is divided into two major categories of benign and malignant.

Postmenopausal bleeding from the common diseases are:

1, vulva, vagina, cervix, the Palace, fallopian tube cancer;

2, vagina, cervix, the Palace in uveitis;

3, uterine fibroids, benign ovarian 4;

4, injury. If sexual intercourse injury;

5, IUD:

6, systemic bleeding disorders.

But the most common diseases: senile vaginitis, cervicitis, cervical cancer, endometritis and endometrial cancer.

Therefore, when postmenopausal bleeding to attention. The importance of timely medical treatment. Do not delay.

First, indications:

1, unprotected sexual intercourse: (a) not to take contraceptive measures - especially the first sexual intercourse was unprotected sex. (b) sexual intercourse interrupted - failed to take out the penis from the vagina lead to ejaculation in the vagina. (c) in the vagina extraoral ejaculation. (d) the date of rhythm contraception in the wrong (cyclical contraception, law-controlled natural contraception)

2, condoms break down, falling in the vagina or other inappropriate use.

3, vaginal diaphragm, cervical cap placed improperly, the process of shedding sexual intercourse, or premature rupture out.

4, IUD partial or complete loss.

5, in certain special circumstances in the period from mid-ring.

6, before and after ovulation, women only a spermicidal contraceptive agent.

7. Improper use of oral contraceptives - when the leak serving drug-free interval to extend the period to nine days or longer, (that is, leakage clothes two or two above), but also in this period whether the protection of sexual intercourse. If the previous seven days served two missed two or more drugs, doctors can give emergency contraception, even if the clothes contraceptives have been seven days, seven days after the leakage clothes contraceptive protection role will disappear. When taking the pill in the mid-1, 2 or leakage served three drugs used emergency contraception is unnecessary. Speaking from the experience of serving as a leakage or three more patients with serious anxiety to emergency contraception when it is appropriate.

8, leakage simple clothes progesterone pill - if the leak first-served to re-start the medication for 48 hours between unprotected sexual intercourse are in need of emergency contraception.

9, sexual assault - regardless of whatever nature are in need of emergency contraception, and in these circumstances not to consider the proceedings, and other issues. Doctors should take into account the possibility of sexually transmitted diseases. Long-term psychological support should not be overlooked.

Second, the taboo of:

1, suspected pregnancy: composite films, IUD taboo.

2, ectopic pregnancy: composite film is not taboo, IUD Menstrual to the next if the removal is a relatively taboo.

3, thrombosis history: composite film relatively taboo, IUD acceptable.

4, attendance at Piantou pain: a composite-only focus of previous partial headache Tabu when, IUD acceptable.

1, sexual partners more stable, more frequent sexual activity of women, relatively more of their daily lives, more stable mood, menstrual cycle if there are laws, they can choose rhythm contraception. Rhythm in the non-use of condoms or contraceptives to film contraception.

2, if it is fixed with the boyfriend cohabitation, sexually transmitted diseases in low-risk, high efficiency and stability can choose the IUD. Clinical Practice tips, sexual partners of unmarried women stability IUD use is safe. However, due to female infertility uterine wall muscle tension, high sensitivity, the intrauterine device easy to transfer or loss, should be strengthened follow-up, regular B-ring investigation, reducing failure. For such women as a suitable choice is short-acting oral contraceptives, third-generation oral contraceptives with low-dose, highly efficient, and less side-effects of pregnancy after treatment to the advantage for married or cohabiting and suspense do not want the children Women.

3, the female sexual partners of instability, as easy sense of sexually transmitted diseases, AIDS, sexual safety, sexual health point of view, should use condoms, contraception. Condoms easy to use, effective and side effects of small, and easy to use in the (pharmacy and the sale of condoms sets of machines for convenience), contraception and prevention of sexually transmitted diseases has a dual effect.

Many pregnant women are due to the non-preparedness of life caused by can not help but love the cause. This “feeling of Suozhi” is not “well prepared”. If you have taken place without the sex life of contraception, should be immediately adopted emergency contraception. Emergency contraception can also be used for contraceptive failure, such as condoms break or slip, missed serving the pill, the wrong count rhythm. If these unprotected sex life after a timely manner to take urgent measures to prevent most abortions.

Repeated abortions can pelvic inflammatory disease, secondary infertility, and other diseases, seriously affecting women’s reproductive health. Therefore, we advise unmarried women, in the absence of protection of life after emergency contraceptive methods should be adopted. Emergency contraception is characterized by: (1) is limited to emergency use, rather than as a conventional method used. (2) only in non-protected sexual intercourse before use. (3) emergency contraception is to prevent unintended pregnancies, abortions after the failure of a contraceptive measures.

Leucorrhea elements: the vaginal epithelial secretions, is to maintain a moist vagina the main substances; cervical and endometrial glands of the discharge, less volume, the nature of the different phases of the menstrual cycle and changes in the vaginal epithelial cells exfoliated And interleukin; labia minora from the sebaceous gland secretions; vestibule of the gland secretions such as.

Leucorrhea secretion: Generally speaking, Leucorrhea tasteless, not quantity, it is because of people because of the different phases of the menstrual cycle and change. If ovulation period of cervical endometrial cells secreting glands strong, therefore increasing Leucorrhea, Jisi thin transparent egg white, with two fingers pull cervical mucus, which can be extended to several centimetres constantly, flexibility is good, if the latter half of the menstrual Less than the observation of this phenomenon. 2-3 days before and after menstruation, due to pelvic congestion, increased vaginal discharge, Leucorrhea also, in some cases, slightly blood, Huang function will be slightly less than brown.

Guoxingshenghuo married women (including pre-marital sexual fantasies, sexual masturbation, sexual impulses) because of the excitement caused by pelvic congestion, then a substantial increase in vaginal secretion, Leucorrhea increased significantly, the longer the stimulus, the more strongly stimulated, secretions Also the more. These are normal physiological phenomena and physiological responses.

However, despite the attention of some women clean, but has a lot of Leucorrhea; smell great, it is Yanbi or Leucorrhea color and nature of significant changes, prompted unusual situation. Married women in these circumstances, the first consideration is with the issues related to sexual activity.

Leucorrhea anomaly: reproductive tract inflammation is usually the performance of married women in general increase the chance of infection, and they often Guoxingshenghuo have a great relationship. When the man did not wash hands caressing, long fingernails Cangwunagou; roommate before the two sides do not pay attention to one side or the lower body cleansing, especially the poor man, health habits; man with phimosis or foreskin is too long, Lanyu roommate after urination and cleaning, etc. Leucorrhea women are very important reasons.

Leucorrhea through the color, smell, the nature of the initial judgement of the disease can type:

Septic bacterial infection, was Leucorrhea Nongxing, yellow or yellow-green, viscous pus-like, smell, such as senile vaginitis, endometritis, intrauterine empyema, a common gonococcal vaginitis, non - Gonococcal vaginitis (Chlamydia infection).

Fungal infection, Leucorrhea was rubbish-like, with obvious genital itching, such as candida infection.

Trichomonas infection, Leucorrhea was milky white foam, vaginal Qiyang.

However, the performance is not unusual Leucorrhea the so typical, let alone often in mixed infections, so the appearance of just a simple judgement is not clear diagnosis, to the best for routine gynecological examination in order to get a clear diagnosis and timely treatment. In particular, the two sides with one party or dirty history of sexual intercourse should be more positive for medical treatment, the best treatment to the skin by sexually transmitted diseases, to prevent misdiagnosis or missed. Currently, the medical profession on the bacterial (including gonococcal), fungal, trichomonas vaginal infections have corresponding effective drugs, after identifying the reasons for specific targets can be an effective treatment. Leucorrhea blood of patients, particularly older post-menopausal patients have been or should be more vigilant, as soon as possible for medical treatment, so as to avoid delay in the diagnosis and treatment of cancer. In addition, but also highlighted the fact that patients suffering from gonorrhea or trichomoniasis, a married couple must both Tongzhi, or rule-woman, the man is still infected with pathogenic microbes or who will be cured by the woman’s sex life and re-infection .

Prevention in the treatment of the principle here is still valid, in order to protect women’s physical and mental health of both men and women should pay attention to sexual health, especially her husband can not even suspected of trouble, we must adopt good hygiene practices. One must do two very important is:

(1) phimosis patients as soon as possible to circumcision, the foreskin is too long, although not non-surgery can not do this, but at least in the former roommate Fanqi foreskin should be properly cleaned.

(2) the man daily cleaning lower body, the former roommate should be noted there will be more likely to have sexual contact with the site are clean.

In addition to cleaning the woman’s former roommate, roommate after urination and should be cleaned once again lower body. We must pay attention to peacetime use of towels and wash basins and towels and Jiaopen separate feet. Selection of squat toilets as far as possible, no alternative to sitting at the pad should also be used toilet paper, paper towel back and polished by the former, washing Qinhuan ground with menstruation, not stingy with sanitary napkins, etc., can prevent the occurrence of unusual Leucorrhea.