妊娠期急性阑尾炎68例分析

目的研究妊娠期急性阑尾炎的临床特点和处理原则。方法对妊娠合并急性阑尾炎68例的诊治进行回顾性分析。结果保守治疗15例,手术治疗53例,手术前后诊断不符13例,诊断符合率75.5%(40/53);治愈67例,死亡1例,死亡率1.47%;流产、死胎及早产新生儿死亡共14例,胎儿损失率20.6%(14/68),其中阑尾穿孔者胎儿损失率为41.2%(7/17),明显高于未穿孔者胎儿损失率13.7%(7/51),P<0.05。结论妊娠合并急性阑尾炎一旦诊断成立应及早手术,在处理上外科医生应与产科医生互相配合,除应顾及孕妇本身的安全外,还须考虑到是否有流产、早产以及胎儿是否能存活等问题。

Analysis of 68 cases of pregnancy with acute appendicitis

Objective Study on the clinical characteristics and principal of treatment for pregnancy with acute appendicitis. Methods The diagnosis and treatment for 68 cases of pregnancy complicated with acute appendicitis were retrospectively evaluated. Results Reserved treatment was applied on 15 patients.Operation was put on 53 patients.Incorrespondence of diagnosis for 13 patients in preoperation and postoperation,correspondence rate of diagnosis was 75.5%(40/53).67 patients were cured,1 patient died.The death rate was 1.47%. There were 14 patients with abortion,fetal death and premature delivery.The fetal loss rate was 20.6%(14/68).The fetal loss rate was significantly higher in patients with perforating appendicitis than that in patients with non-perforating appendicitis Objective Study on the clinical characteristics and principal of treatment for pregnancy with acute appendicitis. Methods The diagnosis and treatment for 68 cases of pregnancy complicated with acute appendicitis were retrospectively evaluated. Results Reserved treatment was applied on 15 patients.Operation was put on 53 patients.Incorrespondence of diagnosis for 13 patients in preoperation and postoperation,correspondence rate of diagnosis was 75.5%(40/53).67 patients were cured,1 patient died.The death rate was 1.47%. There were 14 patients with abortion,fetal death and premature delivery.The fetal loss rate was 20.6%(14/68).The fetal loss rate was significantly higher in patients with perforating appendicitis than that in patients with non-perforating appendicitis [41.2%(7/17) vs 13.7%(7/51),P<0.05].Conclusion Operation must be done as soon as possible when pregnancy complicated with acute appendicitis has been diagnosed.Surgeon must be mutual cooperation with obstetrician.Besides care for a safety of gravida,whether there are abortion,premature delivery and fetal survival,etc should be considered.