课件：妇科急腹症.ppt

* * * * * * * * 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  This ovary is dark and enlarged from hemorrhage following torsion. Torsion of the ovary is uncommon but may occur in adults in conjunction with benign ovarian cysts or neoplasms and in children or infants spontaneously. It leads to a presentation like that of acute appendicitis, but an adnexal mass may be palpable. Torsion of the ovary 病史 输卵管 黄体 流产 卵巢囊肿 急性输 急性阑  妊娠 破裂 蒂扭转 卵管炎 尾炎 停经 多有 多 有 无 无 无 腹痛 突然撕裂 突发下 下腹中央 突发下 两下腹持 转移性  样一侧向 腹一侧 阵发坠痛 腹一侧 续性疼痛 右下腹痛  全腹 阴道 少，暗红 无或如 少至多 无 无 无 流血 蜕膜管型 月经量 鲜红血块