卵巢子宫内膜异位囊肿合并感染32例临床分析

发布时间：2018-06-02 10:52

本文选题：卵巢子宫内膜异位囊肿 + 盆腔脓肿　；参考：《实用妇产科杂志》2017年01期

【摘要】：目的:探讨卵巢子宫内膜异位囊肿合并感染的临床特点及诊治策略。方法:回顾性研究2000年1月至2016年1月在北京协和医院住院且经手术病理证实为卵巢子宫内膜异位囊肿合并感染的32例患者,分析其临床特点、诊治经过及预后。结果:56.3%(18/32)的患者同时表现出发热、腹痛及盆腔包块。3例(9.4%)重症患者出现感染性休克。术前正确诊断率12.5%(4/32)。腹腔镜手术组较开腹手术组手术时间短、术中出血量少、术后肛门排气时间短(P0.05);急诊手术组和择期手术组患者手术过程及术后恢复差异无统计学意义(P0.05)。随访率71.9%(23/32),中位随访时间72月(7~191月)。1例患者术后8月盆腔脓肿复发,复发后保守治疗成功;3例患者术后6~12月卵巢子宫内膜异位囊肿复发。7例不孕患者,2例体外受精-胚胎移植(IVF-ET)妊娠至活产。结论:卵巢子宫内膜异位囊肿合并感染半数以上患者可同时出现发热、腹痛及盆腔包块,严重者甚至出现感染性休克。术前诊断率低。手术是主要治疗方式,腹腔镜手术有一定的优势,必要时应行急诊手术。
[Abstract]:Objective: to investigate the clinical features, diagnosis and treatment of ovarian endometriosis cyst complicated with infection. Methods: from January 2000 to January 2016, 32 patients with ovarian endometriosis complicated with infection were studied retrospectively. Their clinical features, diagnosis and treatment and prognosis were analyzed. Results the patients with 15% of the patients showed fever, abdominal pain and pelvic mass of 9. 4) severe patients with septic shock. The correct diagnosis rate before operation was 12.5 / 32%. The operative time of laparoscopic operation group was shorter than that of open operation group, the amount of blood lost during operation was less, and the time of anal exhaust was shorter than that of operation group (P 0.05), while there was no significant difference in the operation process and postoperative recovery between emergency operation group and elective operation group (P 0.05). The follow-up rate was 71.9% and 23 / 32%. The median follow-up time was 72 months and 7 ~ 19.1 cases of pelvic abscess recurred after operation. 3 patients with ovarian endometriosis recurred from 6 to 12 months after recurrence and 2 patients with IVF-ETT were pregnant to live delivery. Conclusion: fever, abdominal pain, pelvic mass and even septic shock may occur in more than half of patients with ovarian endometriosis complicated with infection. The preoperative diagnosis rate was low. Surgery is the main treatment, laparoscopic surgery has some advantages, if necessary, emergency surgery should be performed.
【作者单位】：中国医学科学院北京协和医院;
【分类号】：R713.6

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