妊娠合并急性阑尾炎的早期诊断和外科治疗(附26例报告)

The early diagnosis and surgical treatment of acute appendicitis in pregnancy

目的探讨妊娠合并急性阑尾炎的早期诊断及手术治疗方法。方法回顾性分析2003年5月-2006年12月河南省安阳市妇幼保健院手术并经病理检查确诊的26例妊娠合并急性阑尾炎临床资料。结果术前明确诊断23例,术前疑诊3例。均及时行阑尾切除术,从入院至手术平均时间4.7h,术后2例切口感染,无流产、早产、胎儿宫内窘迫及死胎等并发症发生。所有病例均获随访,平均随访时间10.5月,1例术后4月发生轻度粘连性肠梗阻,保守治愈;余无症状生存。结论根据妊娠合并急性阑尾炎临床特点对其做出及时诊断和手术治疗,是保证临床效果及母婴安全的重要手段。

Objective To explore the early diagnosis and suigical treatment of acute appendicitis in pregnancy. Methods The clinical data of 26 patients diagnosed with acute appendicitis in pregnancy and treated by operation were analyzed. Results The preoperative definite diagnosis on acute appendicitis in pregnancy was achieved in 23 cases and 3 case were suspected. All the patients were operated with appendectomy in time and the average time was 4.7 hours from admission to operation. No complication happened in the near future except 2 cases happened on incision infection. All the patients were followed up and the average followed - up time was 10.5 month. Only one case were complicated with adhesive ileus after postoperative - 4 - month. Conclusions According to the clinical characteristics of acute appendicitis in pregnancy, to confirm it early and to operate it with appendectomy in time is an important way to good result for gravida and fetus.