妊娠合并急性阑尾炎24例临床特点及诊治分析

目的:探讨妊娠合并急性阑尾炎的临床特点及其诊断与治疗。方法:我院2005年1月～2009年6月收治妊娠合并急性阑尾炎患者24例,所有患者均出现腹痛症状,外周血白细胞计数均>10×109/L,20例采用阑尾切除术治疗,4例采用保守治疗,观察其治疗效果及病理情况。结果:20例手术患者均手术成功,其中6例阑尾切除术前行剖宫产术,术后无流产、切口感染及产妇死亡情况。4例保守治疗患者中3例治疗无效改行手术治疗,1例保守治疗患者症状缓解,无流产、早产。术后病理诊断,5例急性单纯性阑尾炎,10例急性化脓性阑尾炎,3例慢性阑尾炎急性发作,3例坏疽性阑尾炎,2例阑尾穿孔。结论:对于妊娠合并急性阑尾炎患者,准确诊断和及时治疗是关键。

Clinic analysis of 24 pregnance cases complicated with acute appendicitis

Objective：To discuss the clinic feature,diagnosis and treatment of pregnancy complicated with acute appendicitis.Methods：Selected 24 pregnancy cases complicated with acute appendicitis admitted from January 2005-June 2009.All patients had abdominal pain,and peripheral blood leucocyte 〉10×10^9/L.Twenty cases had appendectomy,and 4 had conservative treatment.Observed the effect and pathological status.Results：Twenty cases had successful surgery incluing six cases with cesarean section before appendectomy,in which no abortion,incision infection or death occurred.Three cases with conservative treatment turned to surgery,and the other one was in relief,in which no abortion and early delivery occurred.The postoperative pathological diagnosis showed 5 cases with simple acute appendicitis,10 cases with acute suppurative appendicitis,3 chronic appendicitis cases with acute attach,3 gangrenous appendicitis cases and 2 cases with appendiceal perforation.Conclusion：The diagnosis and treatment in time are the key for pregnancy with complication of acute appendicitis.