Brun Jean-Luc, Graesslin Olivier, Fauconnier Arnaud, Verdon Renaud, Agostini Aubert, Bourret Antoine, Derniaux Emilie, Garbin Olivier, Huchon Cyrille, Lamy Catherine, Quentin Roland, Judlin Philippe
Department of Gynecology and Obstetrics, Pellegrin University Hospital, Bordeaux, France.
Department of Gynecology and Obstetrics, Alix-de-Champagne University Hospital, Reims, France.
Int J Gynaecol Obstet. 2016 Aug;134(2):121-5. doi: 10.1016/j.ijgo.2015.11.028. Epub 2016 Apr 19.
Pelvic inflammatory disease (PID) is commonly encountered in clinical practice.
To provide up-to-date guidelines on management of PID.
An initial search of the Cochrane database, PubMed, and Embase was performed using keywords related to PID to identify reports in any language published between January 1990 and January 2012, with an update in May 2015.
All identified reports relevant to the areas of focus were included.
A level of evidence based on the quality of the data available was applied for each area of focus and used for the guidelines.
PID must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade C). Pelvic ultrasonography is necessary to exclude tubo-ovarian abscess (grade B). Microbiological diagnosis requires vaginal and endocervical sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ofloxacin and metronidazole for 14days (grade B). Treatment of tubo-ovarian abscess is based on drainage if the collection measures more than 3cm (grade B), with combined ceftriaxone, metronidazole, and doxycycline for 14-21days.
Current management of PID requires easily reproducible investigations and treatment, and thus can be applied worldwide.
盆腔炎性疾病（PID）在临床实践中较为常见。
提供最新的PID管理指南。
最初检索了Cochrane数据库、PubMed和Embase，使用与PID相关的关键词来识别1990年1月至2012年1月期间以任何语言发表的报告，并于2015年5月进行了更新。
纳入所有与重点领域相关的已识别报告。
根据可用数据的质量为每个重点领域应用证据级别，并用于制定指南。
当自发性盆腔疼痛伴有诱发性附件区或子宫疼痛时，必须怀疑PID（C级）。盆腔超声检查对于排除输卵管卵巢脓肿是必要的（B级）。微生物学诊断需要采集阴道和宫颈管样本进行分子和细菌学分析（B级）。单纯性PID的一线治疗是氧氟沙星和甲硝唑联合使用14天（B级）。如果脓肿直径超过3cm，输卵管卵巢脓肿的治疗基于引流（B级），联合头孢曲松、甲硝唑和多西环素治疗14 - 21天。
目前PID的管理需要易于重复的检查和治疗，因此可在全球范围内应用。
