妇科急腹症手术324例临床分析

目的:探讨妇科急腹症手术的病种构成及影响术前正确诊断的相关因素。方法:选择因急腹症住院手术的妇科患者324例,对其临床表现及术中、术后等情况进行综合分析。结果:出血性疾病272例,其中异位妊娠255例、黄体破裂15例、结扎术后盆腔血肿1例、腹壁卒中1例;感染性疾病10例,其中盆腔脓肿9例、出血性输卵管炎1例;卵巢肿瘤并发症38例,其中卵巢肿瘤蒂扭转28例、卵巢囊肿破裂7例、急性化脓性阑尾炎合并卵巢囊肿2例、卵巢囊肿囊内出血1例;子宫疾病3例,其中子宫肌瘤并发症2例、子宫内膜癌1例;肠癌合并盆腔脓肿1例。结论:对妇科急腹症患者,抗炎对症治疗临床症状不能改善者应及时剖腹探查,对术中与临床表现不相符的应仔细检查邻近器官,防止遗漏内、外科病症。

Gynecologic acute abdomen: Clinical analysis in 324 cases

Objective：To explore the gynecologic diseases associated with acute abdomen required surgery and influential factors leading to preoperative misdiagnosis. Methods：The clinical data were retrospectively analyzed in 324 female patients with acute abdomen,who were required inpatient surgical treatment,regarding the clinical manifestation,intra-and post-operative findings. Results：Of the 272 cases with gynecological intra-abdominal hemorrhage,ectopic pregnancy was found in 255,ruptured corpus luteum in 15,hematoma pelvis secondary to tubal ligation in 1 and abdominal apoplexy in 1. Ten cases were results of infection,in which 9 were due to pelvic abscess and 1 hemorrhagic salpingitis. Thirty-eight were the complications from ovarian tumor,in which torsion of the pedicle of ovarian cyst was found in 28,ruptured ovarian cyst in 7,acute appendicitis associated with ovarian cysts in 2 and internal hemorrhage of ovarian cysts in 1. Of the 3 cases with disease of uterus,association with uterine fibroids was seen in 2,cancer of endometriun in 1 and intestinal cancer associated with pelvic abscess in 1. Conclusion：In treatment of gynecologic acute abdomen,the patients should undergo exploratory laparotomy given clinical symptoms failed to respond to anti-inflammatory intervention. Besides,examination of the adjacent organs is recommended to those whose intra-operative findings are not consistent with clinical conditions to prevent neglect of involved internal or surgical diseases.