基层医院妊娠期阑尾炎诊治经验.docVIP

基层医院妊娠期阑尾炎诊治经验【摘要】 目的 探讨妊娠期阑尾炎的发病特点，诊断和治疗。方法 回顾分析46例妊娠期阑尾炎的临床资料。结果 46例患者中21例行保守治疗，25例手术治疗，其中3例为保守治疗12 h病情病情无缓解，采取手术治疗。21例保守治疗患者，均痊愈出院，出院后随访，胎儿存活16例，2例要求术后流产，3例失访。25例手术治疗患者，22例恢复良好，3例切口感染。出院后随访，胎儿存活21例，1例因坏疽性阑尾炎导致死胎。结论 妊娠期急性阑尾炎病情特殊，发展快，应正确掌握手术指征，在治疗阑尾炎的同时尽量保证胎儿的存活。? 【关键词】 基层医院；妊娠期；阑尾炎；诊治??The treatment experience ofgestational appendicitis inbasic level hospitals FENG Xiao?dong,TAN Wei?bing,GU Di?heng, et al.Department of General Surgery, Shuangfenghospital of Taicang City, Jiangsu 215400,China ? 【Abstract】 Objective To explore the clinical characteristic,diagnosis and treatment of pregnancy appendicitis. Methods The clinical date of 46 cases of pregnancy appendicitis were reviewed.Results 21 routine conservative treatment, 25 cases of surgical treatment, including 3 cases of conservative treatment 12 hours without relief, adopt illness condition surgery in 46 patients.21 cases of conservative treatment, all patients recovered well, all patients were observed during follow-up after discharge from hospital, fetal live in 16 cases,2 patients required postoperative abortion, 3 cases lost to follow-up. 25 cases of surgical treatment of patients, 22 patients recovered well, 3 cases incision infection. After discharge follow-up, 21 cases of fetal live, 1 case for gangrene appendicitis cause stillbirth.Conclusion Pregnancy appendicitis illness, and quick development, should bemaster the indications of operation, at the same time try to ensure the survival of the fetus.? 【Key words】 Basic level hospital; Gestational;Appendicitis;Diagnosis ? 急性阑尾炎是妊娠期较常见的外科并发症。因妊娠期病程发展快，易形成穿孔和腹膜炎，因而是一种严重的合并症，早期诊断和处理极为重要。我院自2008年1月至2010年1月共收治妊娠期阑尾炎病例46例，现报告如下。? 1 资料与方法? 1.1 一般资料 本组患者中年龄22~36岁，平均24.3岁，其中早期妊娠12例，中期妊娠26例，晚期妊娠8例，既往有“慢性阑尾炎”病史5例，就诊时间2~36 h，平均15.6 h。出现转移性右下腹痛26例，持续性右下腹痛12例，右腰背痛6例，全腹痛2例。伴恶心呕吐38例，畏寒发热22例，其中体温38℃~39℃ 18例，39℃ 4例，腹泻4例。查体：麦氏点压痛20例，麦氏点偏上2~4 cm压痛22例，右腰背压痛4例。肌紧张8例，反跳痛6例。辅助检查：白细胞升高42例，其中WBC:(10~15)×10?9 31例，15×10?9 11例。? 1.2 治疗方法 46例患者，21例症状较轻行保守治