妊娠合并急腹症45例临床分析

发布时间：2018-05-26 06:10

本文选题：妊娠 + 急腹症　；参考：《大连医科大学》2013年硕士论文

【摘要】：急腹症是以急性腹痛为主要表现，需要早期诊断和及时处理的腹部疾病。妊娠合并急腹症，具有起病急，进展快、临床表现复杂多样、涉及病种繁多的特点，易导致误诊、漏诊，一旦延误治疗，将严重威胁母婴的健康。早期识别和正确的处理妊娠期急腹症，对改善母婴的预后有着极其重要意义。因此，总结和分析妊娠合并急腹症的临床特征和治疗方法，有利于在今后临床工作中减少失误，提高诊断和救治水平。目的：讨论妊娠合并急腹症的临床特点和处理方法，提高妊娠期急腹症的诊断和治疗水平。方法：收集2006年5月～2012年12月经大连医科大学附属第一医院收治的45例妊娠合并急腹症患者的临床资料，进行回顾性分析。结果：妊娠合并急腹症45例中，急性阑尾炎23例（51.11%）;急性胃肠炎10例（22.22%）；急性胆囊炎3例（6.67%）;急性胰腺炎4例（8.89%）;肠梗阻3例（6.67%）；肠穿孔1例（2.22%）；卵巢脓肿1例（2.22%）。手术治疗18例（40.00%）；保守治疗27例（60.00%）。早产4例（8.89%）；流产3例，其中2例为家属要求终止妊娠（6.67%）。误诊3例，其中阑尾炎误诊1例（25+6W），，肠穿孔误诊1例（35+4W），卵巢脓肿误诊1例（38+6W），误诊患者平均年龄25岁，误诊率为6.67%。结论：妊娠急腹症因其特殊的解剖、生理变化，容易出现诊断困难，需要产科医师和内、外科及相关科室密切合作、提高意识、共同参与，以减少误诊，使患者得到积极合理的治疗。处理妊娠合并急腹症时，不应因妊娠而改变手术指征，但需兼顾孕妇和胎儿的安全，合理的手术治疗不会增加流产、早产及胎儿损失。
[Abstract]:Acute abdomen is an abdominal disease characterized by acute abdominal pain, which needs early diagnosis and timely treatment. Pregnancy complicated with acute abdomen, with rapid onset, rapid progress, complicated and diverse clinical manifestations, involving a wide variety of disease characteristics, easy to lead to misdiagnosis, missed diagnosis, once delayed treatment, will seriously threaten the health of mother and child. Early identification and correct treatment of acute abdominal syndrome in pregnancy are of great significance to improve the prognosis of mother and child. Therefore, summing up and analyzing the clinical characteristics and treatment methods of pregnancy with acute abdomen is helpful to reduce errors and improve the level of diagnosis and treatment in the future clinical work. Objective: to discuss the clinical features and management of pregnancy complicated with acute abdomen, and to improve the diagnosis and treatment of pregnancy acute abdomen. Methods: the clinical data of 45 cases of pregnancy complicated with acute abdomen admitted from the first affiliated Hospital of Dalian Medical University from May 2006 to December 2012 were retrospectively analyzed. Results: of the 45 cases of acute abdomen, 23 cases were acute appendicitis, 10 cases were acute gastroenteritis, 3 cases were acute cholecystitis, 3 cases were acute cholecystitis, 4 cases were acute pancreatitis, 4 cases were acute pancreatitis, 3 cases were intestinal obstruction, 1 case was intestinal perforation, 1 case was intestinal perforation, and 1 case was ovarian abscess. Surgical treatment was performed in 18 cases, and conservative treatment in 27 cases. There were 4 cases of premature delivery and 3 cases of miscarriage, of which 2 cases were requested by family members to terminate pregnancy. 3 cases were misdiagnosed, including appendicitis misdiagnosed in 1 case, intestinal perforation misdiagnosed in 1 case, ovarian abscess misdiagnosed in 1 case, the average age of misdiagnosed patients was 25 years old, the misdiagnosis rate was 6.67%. Conclusion: because of its special anatomical and physiological changes, the acute abdomen of pregnancy is easy to be diagnosed. It needs close cooperation between obstetricians and internal, surgical and related departments to raise awareness and participate in order to reduce misdiagnosis. Make the patient get positive and reasonable treatment. The surgical indication should not be changed because of pregnancy, but the safety of pregnant woman and fetus should be taken into account. Reasonable surgical treatment will not increase abortion, premature delivery and fetal loss.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R714.25

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