女性盆腔脓肿60例临床分析

目的探讨女性盆腔脓肿的临床特点和处理方法。方法对2002至2008年在同济大学附属东方医院治疗的60例女性盆腔脓肿患者的临床资料进行回顾性分析,分析其病史、临床表现、入院诊断及治疗方法,并对腹腔镜手术和剖腹探查术的治疗效果进行比较。结果盆腔脓肿大部分发生在育龄妇女,临床表现发热、腹痛及盆腔包块,临床诊断正确率61.6%,误诊率38.4%。所有患者均经腹腔镜及开腹手术治疗,在手术时间、术中出血、术后体温及血象恢复正常的时间、术后感染及住院时间等方面,前者优于后者。结论女性盆腔脓肿病因复杂,临床表现多样,其临床症状缺乏特异性,误诊率高。宫颈分泌物培养和MR I检查在诊断盆腔脓肿中发挥重要作用。治疗以腹腔镜手术治疗效果好,一旦确诊,应尽早手术。

Clinical analysis of pelvic abscess in 60 female cases

Objective To study the clinical features and treatment of pelvic abscess in female patients.Methods Sixty pelvic abscess cases were confirmed by operation retrospectively.Medical history,clinical symptoms,admitting diagnosis and treatment were analyzed.The curative effects of laparoscopic operation and laparotomy were analyzed.Results Pelvic abscess was usually found in the reproductive females.The symptom of fever,lower abdominal pain and pelvic masses were usually found in the pelvic abscess cases.The rate of misdiagnosis was 38.4% in this study.Laparoscopic surgery was more effective than laparotomy in the duration,blood loss,fever,hemogram revovery time,postoperative wound infection and inpatient days.Conclusion The etiology and clinical features are complicated and lack of specificity.The rate of misdiagnosis is rather high in pelvic abscess cases.Cervix secretion culture and MRI play important roles in the diagnosis.Laparoscopic surgery is a better way in treating pelvic abscess cases.Operation should be done as soon as possible when it was diagnosed.