妊娠期急性阑尾炎的诊断及围术期处理

Diagnosis of appendicitis during pregnancy and perioperative management

目的探讨妊娠合并急性阑尾炎的临床特征及处理。方法回顾性分析32例妊娠合并急性阑尾炎的临床资料。结果32例中,处于妊娠早、中期22例,晚期10例。29例表现为右下腹痛,32例均有腹部压痛及消化道症状,发热27例。急诊行阑尾切除术23例,保守治疗9例(其中4例致阑尾穿孔)。合并先兆流产5例,先兆早产6例,胎儿宫内窘迫2例,死胎1例,宫内感染1例。其中死胎、早产和宫内感染均发生于行保守治疗病例。结论妊娠期合并急性阑尾炎的患者,及时的诊断和治疗是处理本病的关键。对于诊断明确,症状、体征严重的患者,不论妊娠周期如何,手术治疗为首选的治疗方法。

Objective To inquire into the characteristics of pregnancy complicated with acute appendicitis. Methods To analyze the clinical data of 32 cases of pregnancy complicated with acute appendicitis retrospectively. Results Among the 32 cases, 22 cases were at early or intermediate stage of pregnancy, the other 10 cases were at late stage.29 cases manifested right hypogastralgia and 27 cases were with fever.All the 32 cases presented abdominal tendernes and gastrointestinal symptoms.23 of the 35 cases were treated with emergency appendectomy.The left 9 cases were administe^d with medical agent treatment .All the complications of fetal death,immature labor and intrauter/ne infection were from the cases who ~cepted medical treatments.Conclusion To diagnosis and treatment in time was the key to manage acute appendicitis during pregnancy：Operation was the first choice for the patients at any stages of pregnancy with confimed diagnosis, severe symptoms.