[1]单龙*,段丽君,孙晓彤,等.孕产期少见型急腹症25例临床分析[J].中国计划生育和妇产科,2019,(7):71-76,89.
　SHAN Long*,DUAN Li-jun,SUN Xiao-tong,et al.Clinical analysis of 25 cases of rare acute abdominal disease during pregnancy and childbirth[J].Chinese Journal of Family Planning & Gynecotokology,2019,(7):71-76,89.
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孕产期少见型急腹症25例临床分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2019年7期
页码:
71-76,89
栏目:
论著与临床
出版日期:
2019-06-25

文章信息/Info

Title:
Clinical analysis of 25 cases of rare acute abdominal disease during pregnancy and childbirth
作者:
单龙*; 段丽君; 孙晓彤; 毛燕; 黄遐; 杨燕; 罗亚莉
甘肃省人民医院妇产科
Author(s):
SHAN Long*;  DUAN Li-jun;  SUN Xiao-tong;  MAO Yan;  HUANG Xia;  YANG Yan;  LUO Ya-li
Department of Obstetrics and Gynecology, Gansu Provincial People's Hospital, Lanzhou Gansu 730000,P.R.China
关键词:
妊娠期; 产褥期; 急腹症; 罕见; 误诊; 分析
Keywords:
pregnancy;  puerperium;  acute abdominal disease;  rare;  misdiagnosis;  analysis
分类号:
R 714.25
摘要:
目的分析孕产期25例少见和罕见急腹症的发病原因、诊疗过程，为临床孕产期急腹症的诊断与鉴别诊断提供借鉴与帮助。方法对甘肃省人民医院2012年7月至2017年7月孕产期25例临床少见急腹症病例进行回顾性分析。结果① 25例少见急腹症病因主要为：妊娠期：腹部卒中2例，子宫肌壁间妊娠1例，胃穿孔1例，子宫破裂3例，宫内妊娠合并异位妊娠破裂2例，子宫阔韧带肌瘤变性1例，子宫浆膜下肌瘤扭转2例，卵巢囊肿扭转坏死2例，妊娠期肝内胆汁郁积症合并重症肝炎和贫血1例，急性化脓性腹膜炎1例，酮症酸中毒1例，输卵管细末小动脉破裂1例。产褥期：子宫浆膜下血管破裂2例，腹肌小动脉破裂1例，腹膜动脉破裂1例，后腹膜及侧腹膜血肿1例，子宫粘连带小动脉破裂2例。② 病例不典型，但均可引起恶心、呕吐、全腹压痛或反跳痛甚至体温、血象及感染指数升高等急腹症症状或体征。③ 难与较常见的急腹症鉴别，易于误诊，误诊率达到113 %，相比常见急腹症误诊率更高。结论在诊断孕产期急腹症时，不仅要想到常见和多发病种，更要与少见和罕见疾病加以鉴别，减少误诊率和提高抢救成功率。
Abstract:
ObjectiveTo analyze the causes and diagnosis and treatment of rare and rare acute abdominal disease in 25 cases during pregnancy and childbirth, and provide reference and help for the diagnosis and identification of acute abdominal disease during clinical pregnancy. MethodsA retrospective analysis of 25 cases of clinically rare acute abdominal disease in Gansu Provincial People's Hospital from July 2012 to July 2017 was conducted. Results① 25 cases of rare acute abdomen were mainly caused by pregnancy: 2 cases of abdominal stroke, 1 case of uterine muscle wall pregnancy, 1 case of gastric perforation, 3 cases of uterine rupture, 2 cases of intrauterine pregnancy with ectopic pregnancy rupture, uterine broad ligament 1 case of fibroid degeneration, 2 cases of uterine subserosal myoma, 2 cases of ovarian cyst torsion and necrosis, 1 case of intrahepatic cholestasis of pregnancy with severe hepatitis and anemia, 1 case of acute suppurative peritonitis, ketoacidosis 1 case, the tubal fine arteries ruptured in 1 case. The puerperium period: 2 cases of uterine subserosal rupture, 1 case of abdominal muscle arteriosus rupture, 1 case of peritoneal artery rupture, 1 case of posterior peritoneal and lateral peritoneal hematoma, and 2 cases of uterine adhesion zone with small artery rupture. ② Cases are not typical, but can cause symptoms or signs of acute abdominal disease such as nausea, vomiting, total abdominal tenderness or rebound tenderness, and even elevated body temperature, blood and infection index. ③ Difficulties and more common acute abdominal disease identification, easy to misdiagnosis, misdiagnosis rate reached 113 %, compared with the common acute abdominal disease misdiagnosis rate is higher. ConclusionIn the diagnosis of acute abdominal disease during pregnancy, not only the common and multiple diseases, but also rare and rare diseases should be identified to help more accurate diagnosis, reduce the rate of misdiagnosis and improve the success rate of rescue.

参考文献/References:

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更新日期/Last Update: 2019-07-25