妊娠合并急性阑尾炎21例临床的的体会.docVIP

妊娠合并急性阑尾炎21例临床的的体会 　　[摘要] 目的:探讨妊娠期急性阑尾炎的治疗方法。方法:1999年6月～2009年6月,本院收治妊娠合并急性阑尾炎患者21例,其中保守治疗2例,腹腔镜阑尾切除术8例,经腹单纯阑尾切除术8例,剖宫产加阑尾切除术2例,经腹阑尾切除加全子宫切除术1例。结果:保守治疗1例流产后手术治疗,8例腹腔镜手术均获成功,无中转开腹,术后恢复好,全部顺利妊娠至足月。8例经腹单纯阑尾切除术,1例术后流产,1例早产,6例继续妊娠。2例剖宫产加阑尾切除术,新生儿无异常。11例开腹手术,2例切口感染,1例粘连性肠梗阻,无其他并发症,无二次手术病例。结论:妊娠期急性阑尾炎宜尽早手术,腹腔镜治疗效果良好,但有适应证。 　　[关键词] 妊娠并发症;阑尾炎;腹腔镜;流产率 　　[中图分类号] R714.25 [文献标识码]A [文章编号]1674-4721(2010)05(b)-034-02 　　 　　Clinical experience of treatment of 21 cases of pregnancy with acute appendicitis 　　WU Yougao1, JI Renfu2, WAN Chamei1 　　(1.Department of Obstetrics and Gynecology, TheFirstPeoples Hospital of Linchuan Area in Fuzhou City, Jiangxi Province, Fuzhou 344100, China;2.Department of General Surgery, The First Peoples Hospital of Linchuan Area in Fuzhou City, Jiangxi Province, Fuzhou 344100, China) 　　[Abstract] Objective: To discuss the therapy of the pregnancy associated with acute appendicitis. Methods: Retrospectively reviewed the 21 cases admitted by our hospital from June 1999 to June 2009 of acute appendicitis in pregnant women. Expectant treatment was on 2 cases. 8 cases of them underwent laparoscopic appendectomy, and 8 cases of them were operated abdominal simplex appendectomy, and 2 cases of them were performed caesarean section with appendectomy, and 1 case of them was delivered abdominal simplex appendectomy with complete hysterectomy. Results: In the expectant treatment, one patient was operated after abortion. 8 operations of laparoscopic appendectomy were all successful without transferring to laparotomy, and all of the patients recovered well and continue pregnancy till the natural term. Among 8 patients of the abdominal simplex appendectomy, one got aborted after operation, one went into labor early, and 6 cases went on with pregnancy. The neonates had no abnormalities in the 2 cases of caesarean section with appendectomy. In the 11 cases of open appendectomy, 2 cases got infected of incisional wound, 1 case had adhesive ileus, but none of them h