妇科重症感染8例病例报道并文献复习

发布时间：2018-06-22 10:24

本文选题：盆腔脓肿 + 重症感染　；参考：《现代妇产科进展》2017年12期

【摘要】：目的:探讨妇科重症感染的临床表现及诊治经验。方法:回顾分析2000年1月至2016年9月于北京协和医院就诊的8例妇科重症感染病例资料并复习相关文献。结果:8例患者临床表现以发热、腹痛、盆腔包块为主,4例(50.0%)出现感染性休克,4例(50.0%)感染病灶累及肠道。急诊手术6例(75.0%),囊肿剔除及脓肿引流2例,患侧附件切除3例,全子宫患/双侧附件切除3例。术后1例切口感染,1例发生小肠穿孔、应激性心肌病,1例肺栓塞。随诊率87.5%(7/8),随诊2~74个月,1例术后8个月盆腔炎复发,保守治疗好转。结论:盆腔脓肿延误诊治及脓肿破裂可引起严重并发症,应及时手术干预。妇科重症感染患者多合并子宫内膜异位症,感染病灶易累及肠道,需多科合作。术后并发症凶险,围手术期严密监护十分重要。
[Abstract]:Objective: to investigate the clinical manifestation, diagnosis and treatment of severe gynecological infection. Methods: the data of 8 cases of severe gynecological infection from January 2000 to September 2016 in Beijing Union Hospital were retrospectively analyzed and the related literatures were reviewed. Results the clinical manifestations of 8 cases were fever, abdominal pain, pelvic mass in 4 cases (50.0%), septic shock in 4 cases (50.0%) and intestinal involvement in 4 cases (50.0%). Emergency surgery was performed in 6 cases (75.0%), cyst excision and abscess drainage in 2 cases, appendectomy in 3 cases, and total hysterectomy / bilateral appendectomy in 3 cases. Postoperative incision infection occurred in 1 case with small bowel perforation and stress cardiomyopathy in 1 case with pulmonary embolism. The follow-up rate was 87.5% (7 / 8). One case of pelvic inflammation recurred from 2 to 74 months after operation and the conservative treatment was improved. Conclusion: the delayed diagnosis and treatment of pelvic abscess and rupture of abscess may cause serious complications. Gynecological patients with severe infection are more complicated with endometriosis. Postoperative complications are dangerous, perioperative close monitoring is very important.
【作者单位】：中国医学科学院北京协和医院妇产科;
【分类号】：R711

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