女性盆腔脓肿的临床诊断附30例分析

Clinical diagnosis of 30 cases with female pelvic abscesses

目的:探讨盆腔脓肿的临床特点,提高诊断水平。方法:对30例女性盆腔脓肿患者的临床资料进行回顾性分析。结果:临床症状以发热及腹痛为主,腹部或盆腔内可触及包块。血清CA-125升高占53.3%,B超检查发现盆腔包块者占93.3%。术前诊断准确率53.3%,误诊率23.3%,漏诊率3.3%。结论;盆腔脓肿术前误诊率和漏诊率较高,综合临床症状、阳性体征、血清CA-125检测,特别是B超检查结果,可提高诊断的准确率。

Objective:To explore the clinical characteristics of pelvic abscess thus to raise the diagnostic standard. Method:Thirty cases with gynecologic pelvic abscesses were retrospectively analyzed.Results:The principal clinical symptoms of pelvic abscess are fever and abdominal pain.Tissue mass is palpated in the abdomen or pelvic cavity and is detected in 93.3%of all cases by the B type ultrasonography.About half of the cases are characterized by an elevated level of serumal CA-125(>30U/ml) .The accuracy of admitting diagnosis was 53.3%,with a misdiagnosis rate of 23.3%and a missed diagnosis rate of 3.3%.Conclusion: There is a comparatively high rate of misdiagnosis and missed diagnosis of pelvic abscess preoperatively.The diagnostic accuracy can be improved by a comprehensive analysis of clinical symptoms,positive physical signs,serumal CA-125 test,especially the results of B type ultrasonography.