妊娠期急性阑尾炎24例诊治体会

目的:探讨妊娠期急性阑尾炎的诊治策略.方法:回顾分析24例妊娠期急性阑尾炎的临床资料.结果:患者均有不同程度的腹痛,多数伴有发热、消化道症状和血常规增高等表现,其中有转移性右下腹疼痛者17例.24例行手术治疗,治愈23例,死亡1例.术后发生并发症者14例,其中流产2例,早产3例.结论:妊娠期急性阑尾炎的诊断较为棘手,随着妊娠月份的增加致使盲肠和阑尾的位置改变,触痛的位置也随之逐渐增高,缺乏麦氏点压痛的典型体征.妊娠期急性阑尾炎一经诊断应尽早手术切除阑尾.围手术期处理的原则是既要保证孕妇安全又要兼顾胎儿生命健康.

Diagnosis and Treatment of 24 Cases of pregnancy with Acute Appendicitis

Objective:To evaluate the diagnosis and treatment of acute appendicitis during pregnancy period.Methods:A retrospective review was conducted for 24 cases with pregnancy appendicitis in our hospital for 10 years.Results:All cases had belly ache.Most of them had fever and high WBC.17 cases were tender in right lower quadrant.All patients were undergone surgery.Of them,23 cases were cured and 1 cases was died.Conclusion:It is difficult to diagnose acute appendicitis during pregnancy.The appendix and vermiform location are changed as the pregnant time increase.The pain location ascend.Typical physical sign of fixed pain is disappeared.After the diagnosis is made,early appendectomy should be performed as soon as possible.The treat principle is not only to ensure the security of pregnant woman,but also to guarantee the life health of foetus.