中晚期妊娠合并非产科急腹症手术时机选择的探讨

发布时间：2018-05-29 05:18

本文选题：妊娠 + 急腹症　；参考：《中国妇幼保健》2016年24期

【摘要】：目的研究分析中晚期妊娠合并非产科急腹症患者手术时机的选择,并探讨手术方案对母婴的影响。方法选择2014年10月-2015年12月天津市西青医院收治的中晚期妊娠孕妇21例为研究对象,所有对象均合并非产科急腹症。回顾性分析患者完整临床资料,探讨分析手术时机的选择以及对母婴的影响,总结临床诊治经验。结果疾病分类:急性阑尾炎8例,占38.1%,附件肿块扭转6例,占28.6%,子宫肌瘤变性2例,占9.5%,卵巢囊肿破裂1例,占4.8%,急性胰腺炎1例,占4.8%,输尿管结石1例,占4.8%,急性胆囊炎1例,占4.8%,急性小肠扭转1例,占4.8%。手术时机:急性阑尾炎、卵巢囊肿破裂、急性小肠扭转、附件肿块扭转、附件肿块扭转以及急性胆囊炎均在入院后6 h内行急诊手术治疗,子宫肌瘤变性及输尿管结石在入院后24 h内手术治疗,急性胰腺炎入院后观察2~4 d后行手术治疗。术中同时行剖宫产8例,占38.1%,术后引产2例,占9.5%。余患者继续妊娠。结论中晚期妊娠合并的急腹症临床特征不典型,对于明确诊断者应及时给予手术治疗,术中根据患者具体情况行个体化处理,保障母婴安全。
[Abstract]:Objective to study the choice of surgical timing in patients with non-obstetrical acute abdomen during middle and late pregnancy and to explore the influence of surgical scheme on mother and child. Methods from October 2014 to December 2015, 21 pregnant women with intermediate and late pregnancy admitted to Xiqing Hospital of Tianjin were selected as study objects. All of them were complicated with non-obstetrical acute abdomen. The clinical data of the patients were analyzed retrospectively, and the choice of operation time and the influence on mother and child were analyzed, and the experience of clinical diagnosis and treatment was summarized. Results there were 8 cases of acute appendicitis (38.1%), 6 cases of adnexal mass torsion (28.6%), 2 cases of uterine myoma degeneration (9.5%), 1 case of ovarian cyst rupture (4.8m), 1 case of acute pancreatitis (4.8%), and 1 case of ureteral calculi (1 case). There were 1 case of acute cholecystitis (4.8%) and 1 case of acute volvulus of small intestine (4.8%). The operative timing: acute appendicitis, rupture of ovarian cyst, acute small intestinal torsion, torsion of adnexal mass and acute cholecystitis were all treated with emergency operation within 6 hours after admission. Uterine myomatous degeneration and ureteral calculi were treated by operation within 24 hours after admission, and 2 to 4 days after acute pancreatitis were observed. Cesarean section was performed in 8 cases (38.1%) and induced labor in 2 cases (9.5%). The remaining patient continued to be pregnant. Conclusion the clinical features of acute abdomen complicated by intermediate and late pregnancy are not typical, the definite diagnosis should be treated with operation in time, and individualized treatment should be carried out during the operation to ensure the safety of mother and child.
【作者单位】：天津市西青医院产科;
【分类号】：R714.2

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