妇科腹腔内出血322例回顾性分析

Analysis of 322 cases abdominal bleeding on gynecology.

目的回顾性分析322例妇科腹腔内出血的诊断和鉴别诊断。方法对我院自1999年10月-2004年10月间收治的322例妇科腹腔内出血病例进行回顾性分析,322例均手术和病理诊断。结果术前诊断299例(92.9%),误诊23例(7.1%),术前诊断率,异位妊娠98.9%(277/280),卵巢破裂69.2%(18/26),出血性输卵管炎9.1%(1/11),巧克力囊肿破裂75.O%(3/4)。结论详细询问病史,血或尿HCG检测,腹部或阴道B超,后穹窿穿刺是重要的诊断手段,尚有待于提高出血性输卵管炎和黄体破裂的术前诊断率。

Objectives To review analysis the diagnosis and differential diagnosis of 322 cases of abdominal bleeding on gynecology. Methods Analyse 322 cases of abdominal bleeding on gynecology in our hospital during October 1999 to October 2004. All cases were confirmed by operation and pathology. Result 299 cases were correctly diagnosed before operation(92. 9%) . 23 cases were misdiagnosed(7. 1%) . The correct diagnostic rate of ectopic pregnancy, ovariorrhexis and hemorrhagic salpingitis was about 98.9%(277/280) ,69.2%(18/26) and 9.1%(1/11).In addition, rupture of endometriosis was 75.0% (3/4). Conclusions Asking about medical history should be detail. Testing human chorionic gonadotropin of blood or urine, ultrasonagraphy on abdomen or vagina and paracentesis vaginal fomix are the most important diagnostic methods. We should improve the diagnostic rate on hemorrhagic salpingitis and ovariorrhexis before operation.