46例卵巢破裂患者临床分析.docVIP

46例卵巢破裂患者临床分析 　　【摘要】 目的：通过对46例卵巢破裂患者的临床分析，探讨卵巢破裂的临床表现、诊断及鉴别诊断，分析此病主要的误诊原因，提出防范措施，并讨论卵巢破裂的合理治疗方式。方法：回顾性总结2014年2-11月本院妇科病房收治的46例卵巢破裂患者的临床症状、体征、治疗方法及结果。结果：46例卵巢破裂患者均表现为突发性持续性腹痛，伴阴道流血、恶心、呕吐、肛门坠胀感等，多有性交等诱因。早期明确诊断41例，确诊率为89.1%（住院的24 h之内）。误诊为异位妊娠2例，误诊为卵巢囊肿蒂扭转2例，误诊为阑尾炎1例，以上误诊的5例患者均经手术确诊为卵巢破裂。保守治疗30例（占65.2%），成功率100%，手术治疗16例（占34.8%）。结论：因卵巢破裂临床表现缺乏特异性，临床医生应加强对此病的认识，在接诊出现急性下腹痛的女性患者时，应行仔细的妇科查体，结合患者的临床表现及相关化验检查综合分析判断，以免误诊。从治疗方法上来说，因卵巢破裂保守治疗的成功率较高，经早期确诊后，应行积极的保守治疗。但如果患者腹腔内出血较多，甚至合并异位妊娠时，应果断实施手术。 　　【关键词】 卵巢破裂； 诊断； 误诊； 保守治疗； 异位妊娠； 卵巢囊肿蒂扭转； 阑尾炎 　　【Abstract】 Objective：Through clinical analysis of 46 patients with ovarian rupture，to investigate the clinical manifestations，diagnosis and differential diagnosis of ovarian rupture，analyze the main causes of misdiagnosis of the disease，preventive measures put forward and discuss reasonable treatment of ovarian rupture.Method：From February 2014 to November 2014，clinical symptoms，signs，treatment and outcome of 46 patients with ovarian rupture were analyzed retrospectively in our hospital .Result：46 cases of ovarian rupture patients showed sudden persistent abdominal pain，many have sexual intercourse and other incentives，with vaginal bleeding，nausea，vomiting，anal flu.Early diagnosis in 41 cases，diagnosis was 89.1%（within 24 hours of hospitalization）.2 cases misdiagnosed as ectopic pregnancy，misdiagnosed as ovarian cyst torsion two cases，one case was misdiagnosed as appendicitis，more than five cases of misdiagnosed patients were diagnosed with ovarian rupture after surgery.Conservative treatment of 30 cases （65.2%），the success rate of 100%，the surgical treatment of 16 cases（34.8%）.Conclusion：Due to lack of specific clinical manifestations of ovarian rupture，clinicians should strengthen awareness of the disease，in patients with acute abdominal pain female admissions occurs，should be performed carefully gynecological examination，combined with clinical manifestations and laboratory tests related to a comprehensive analysis of judgment，in order