妊娠合并急腹症的诊断与治疗分析

Analysis on Diagnosis and Treatment for Acute Abdomen during Pregnancy

目的总结妊娠合并急腹症的诊断、治疗经验与教训。方法对本院1995年2月—2005年5月收治的32例妊娠合并急腹症进行回顾分析。结果急性阑尾炎16例,非手术治疗6例(其中3例成功,另3例失败后转为手术)、手术治愈10例;卵巢囊肿蒂扭转4例,误诊1例,均手术治愈;子宫肌瘤3例,均行非手术治疗,其中1例疗效不佳,后改为子宫肌瘤剔除术;急性胆囊炎、胆道蛔虫各1例,均经非手术治疗缓解;急性胃肠炎6例,均经非手术治疗治愈。32例中除1例术后流产,2例非手术治疗成功后行人工流产外,其余均继续妊娠成功。结论妊娠合并急腹症时,常可使急腹症诊断发生困难并易导致误诊,治疗宜视具体情况选择手术或非手术治疗。

Objective To suminarize the diagnosis of acute abdomen during pregnancy and its treatment experienceMethods Acute abdomen of 32 pregnant women, who were admitted to our hospital during Feb. 1995 and May 2005, was retrospectively analyzed. Results As a result, 16 patients were diagnosed with acute appendicitis. Among them, ten were successfully treated by surgical operation and six were treated by conservative treatment （ three succeeded in conservative treatment and the others turned to surgical operation after failure in conservative treatment）. Four patients diagnosed with ovarian cyst accompanied by twisted pedicel, among whom one was misdiagnosed, healed up by surgical operation. There were three patients diagnosed with hysteromyoma. They were treated by conservative treatment except one that turned to hysteromyomectomy due to failure in the treatment. The two patients with acute cholecystitis or biliary ascariasis reached improvement by conservative treatment, and the six patients with acute gastroenterltis healed up by conservative treatment, too. One patient with urolithiasis achieved his remission of symptoms by antispasmodic and antibiotics. All the 32 women succeeded in maintaining pregnancy except three ones who ended it due to postoperative abortion or induced abortion. Conclusion Dificulty in diagnosis and misdiagnosis may happen to acute abdomen during pregnancy. Surgical operation or conservative treatment can be applied according to its condition.