妊娠合并外科急腹症临床特点及治疗分析.docVIP

妊娠合并外科急腹症临床特点及治疗分析 　【摘要】 目的 探讨妊娠合并外科急腹症临床表现、诊断和治疗方法。方法 回顾性分析本院2000年1月至2010年1月收治的37例妊娠合并外科急腹症的临床资料。结果 37例妊娠合并外科急腹症，其中急性阑尾炎23例，占总数的62.16%；急性胆囊炎4例，占总数的10.81%；急性肠梗阻7例，占总数的18.92%，输尿管结石2例，占总数的5.41%；嵌顿性腹股沟斜疝1例，占总数的2.70%。37例中手术治疗31例，占总数83.78%;保守治疗6例，占总数的16.22%。37例中人工流产4例，自然流产2例，手术同时行剖宫产6例，继续妊娠25例。结论 妊娠合并外科急腹症临床表现复杂，容易延误诊断，一旦明确诊断，且有手术指征，应积极手术治疗，如有产科指征，应同时行剖宫产。 【关键词】 妊娠 外科急腹症 手术治疗 【Abstract】 Objective: To investigate the clinical manifestation and diagnosis and treatment of the pregnancy complicated with Acute abdominal syndrome. Methods: The clinical data of 37 cases with pregnancy complicated with Acute Abdominal syndrome from janury 2000 to Janury 2010 in in our hospital were analyzed retrospectively. Results: In all the cases,23 cases were Acute Appendicitis, The rate was 62.16%(23/37）；The rate of Acute Intestinal obstraction were 18.92%(7/37);The rate of Acate Cho-lecystitus were 10.81%(4/37);The rate of ureter Calculus was 5.41%(2/37);The rate of Incarcerated inguinal hernia was 2.7%(1/37).Operative cases was 31,The rate was 83.78%(31/37);Conservztive treatment cases was 6, The rate was 16.22%(6/37),The complication was 6 cases. Including 4 cases were Abortion and two cases were spontandous abortion.Cesarean section surgery at the same time was 6 cases,25cases were continue pregnancyed. Conclusions: The clinical manifestation of pregnancy complicated withAcute Abdominal syndrome was complex and changeable , It was easy to delay treatmeat.The diagnosis was clear once and comforms to the surgery, the early operative should been done. If obstetric indications was meeting,The cesarean section should been done at the same time. 【Key words】 pregnancy Acute abdominal syndrome operative 妊娠合并外科急腹症临床表现复杂多变，延误诊断和治疗，可造成胎儿死亡，危及孕妇生命。我院2000年1月至2010年1月共收治此类患者37例，现将资料报告如下。 1 临床资料与治疗方法 1.1一般资料 本组37例患者，年龄20-36岁，平均27.8岁。发病至就诊时间1-7天，平均3.1天。妊娠早期（1-3月）13例，中期（4-7月）15例，后期（8个月以上）9例。入院后分别诊断为急性阑尾炎23例，急性胆囊炎4例，急性肠梗阻7例，泌尿系结石2例，腹股沟嵌顿斜疝1例。其临床表现及实验室仪器检查，详见表1 表1 1.2治疗方法 37例患者中18例入院后确诊急