妇科腹腔内出血病因分析及自体血回输的意义探讨

目的分析妇科急性腹腔内出血的不同原因的临床特征以减少误诊及指导治疗,探讨自体血回输的安全性和有效性。方法对收治的352例妇科腹腔内出血患者进行回顾性分析。结果352例妇科腹腔内出血患者术后诊断为:异位妊娠262例,占74.43%,卵巢破裂74例,占21.02%,出血性输卵管炎12例,占3.41%,其他4例,占1.14%。异位妊娠、卵巢破裂和出血性输卵管炎的术前误诊率分别是4.96%,31.08%和66.67%。腹腔内出血在急诊手术中需要输血的患者188例,其中108例采用了自体血回输,无1例发生严重并发症。自体血回输中加或不加抗凝剂,治疗效果及副反应均没有差异。所有患者预后良好。结论妇科急性腹腔内出血的诊断并不困难,大多数能明确其原因。妇科腹腔内出血急诊手术中应用自体血回输治疗是安全、有效的。

Analysis on Etiopathogenisis of Gynaecological Intraabdominal Hemorrhage and Discussion on the Significance of Autologous Blood Transfusion

Objective To analyze the etoppathogenisis and clinical manifestation of gynaecological intraabdominal hemorrhage so as to decrease misdiagnosis and guide treatment;to discuss the safe and efficacy of autologus blood transfusion.Methods A retrospective analysis was made to 352 cases with gynaecological intraabdominal hemorrhage.Results Post-operation diagnosis showed: out of the 352 cases,262 cases with ectopic pregnancy(74.43%),74 cases with ovariorrhexis(21.02%),12 cases with hemorrhagic salpingitis(3.41%) and 4 cases with other causes(1.14%);pre-operation misdiagnosis rate of ectopic pregnancy,ovariorrhexis and hemorrhagic salpingitis was 4.96%,31.08% and 66.7% respectively.188 cases had blood transfusion in the emergent surgery,autologous blood transfusion was performed to 108 cases out of the 188,no serious complications occurred.. There was no difference for curative effect and side effect whether decoagulant was added or not in autologous blood transfusion.All patients showed good prognosis.Conclusion It is not difficult to diagnose gynaecological intraabdominal hemorrhage and most cases have obvious causes;it is safe and effective to perform autologous blood transfusion in emergent surgery for gynaecological intraabdominal hemorrhage.