【医学课件】 妇科急腹症.pptVIP

treatments of Gyneacologic Acute Abdomen（1） 紧急手术： 异位妊娠破裂salpingectomy 卵巢囊肿蒂扭转 巧囊破裂 黄体破裂休克 脓肿破裂 treatments of Gyneacologic Acute Abdomen（2） 暂缓手术： 异位妊娠流产 salpingectomy or Conservative surgical treatment 壶腹部－切开取出 伞部－挤压出expression of the pregnancy from the tube 峡部－切除断端吻合术 卵巢囊肿蒂扭转有缓解 黄体破裂 急性盆腔炎保守治疗无效、脓肿形成 treatments of Gyneacologic Acute Abdomen （3） 保守： 异位妊娠流产 黄体破裂 急性盆腔炎药物控制有效 ectopic pregnancy medical treatment指征： a.妊娠囊3cm b.未破裂或流产型 c.无明显内出血 d.β-HCG3000u/L 保守治疗 异位妊娠流产 黄体破裂 急性盆腔炎 中药治疗 止血 支持治疗 化疗药物 抗炎 足量广谱 抗炎 抗生素 A right tubal ectopic pregnancy as seen at laparoscopyThe swollen right tube containing the ectopic pregnancy is on the right at EThe stump of the left tube is seen at L - this woman had a previous tubal ligation   ? ? ?  Close view of the same ectopic After laparoscopic resection of the tube, the tubal stump is seen at S  Ovarian ectopic pregnancyOvary is the white structure in the middlePregnancy implanted on the far right side of the ovary at the XBleeding and clotted blood are seen here around the ovaryOvarian pregnancies are quite rare  妇科急腹症 Gyneacologic Acute Abdomen 以腹部疼痛为主要症状的一组妇科急症。 腹痛 是这三种疾病的主要症状 急：发病突然，症状重，危及生命 ectopic pregnancy extrauterine pregnancy torsion of the ovarian pedicle twisted ovarian cysts acute pelvic inflammatory disease a ruptured ovarian lutia Endomitriosis story Acute abdominal pain wanted to give bowels the abdomen rigidity and tenderness、rebound tenderness. pass water fainted on the spot blood presure was zero Diagnosis? ectopic pregnancy  Ectopic Pregnancy  Definition: Ectopic pregnancy is defined as pregnancy outsied the uterine cavity Most common site of occurrence is the fallopian tube tubal pregnancy 88.5% ovarian pregnancy 4.5% cervical pregnancy 0.7% pregnancy in rudimentary horn 1.5% pregnancy in interstitial 4.8%abdominal pregnancy 4 7 8 6 3 1 2 5 the UK : 0.25-1% getting more common. In