妇科急腹症767例临床分析

Clinical Analysis of 767 Patients with Gynecological Acute Abdomen

目的:探讨妇科急腹症的诊断和鉴别诊断以减少误诊。方法:回顾性分析我院1995年10月至2004年5月767例妇科急腹症的临床资料。结果:异位妊娠和卵巢肿瘤蒂扭转的急诊诊断和术后诊断符合率为100%,卵巢破裂误诊率为56.4%,出血性输卵管炎误诊率为70%,2例卵巢巧克力囊肿均误诊。不全流产、难免流产、痛经和急性盆腔炎基本无误诊。结论:详细询问病史,细致的体格检查,血、尿HCG,B超检查和后穹隆或腹腔穿刺术是明确诊断妇科急腹症简便而重要的手段。

Objective: To probe the diagnosis and differential diagnosis of gynecological acute abdomen in order to reduce the mistaken diagnosis. Methods: 767 cases of gynecological acute abdomen were analyzed retrospectively from Oct, 1995 to May, 2004 in the hospital. Results: The corrective rate of the emergency diagnosis and postoperative diagnosis of ectopic pregnancy and twisting the base of ovarian tumor reached 100 percent. The rate of mistaken diagnosis of rupture of ovary and hemorrhagic oviduct were 56.4 % and 70%. Two cases ovary endometriosis mistakenly diagnosed. There weren't any mistaken diagnosis in incomplete abortion, unavoidable abortion, dysmenorrhoea and acute pelvic infection. Conclusion: Enquiring the medical history in detailed, careful physical examination, detecting blood\urine HCG level, B,ultrasonography examination and culdocentesis or abdominocentesis are convenient and important diagnostic methods.