出血性输卵管炎误诊11例分析

Analysis of misdiagnosis in 11 cases with hemorrhagic salpingitis

目的:探讨出血性输卵管炎的诊断要点及鉴别诊断,分析出血性输卵管炎的误诊原因,减少误诊的发生。方法:总结出血性输卵管炎的临床资料,分析术前和术后诊断不符的原因。结果:本组11例均误诊,其中3例误诊为异位妊娠,2例误诊为卵泡破裂,4例误诊为黄体破裂,2例误诊为急性阑尾炎。术后病理学检查均确诊为出血性输卵管炎。结论:出血性输卵管炎临床表现复杂多样,根据近期内有宫腔操作及感染史,详细询问有无真正的停经史,有无体温增高及白细胞增高,后穹窿穿刺抽得不凝血,再结合B超及尿HCG或血-βHCG检查常可确诊。提高对出血性输卵管炎的认识,重视病史的询问及熟练掌握诊断要点是减少误诊的关键所在。

Objective To explore the diagnosis highlight and differential diagnosis of hemorrhagic salpingitis,and analyze the reasons of misdiagnosis of hemorrhagic salpingitis,in order to reduce the misdiagnosis.Method The clinical data of cases with hemorrhagic salpingitis were summarized,and the reasons of diagnosis mismatch between pre-surgery and post-surgery were analyzed.Results All 11 cases was misdiagnozed,3 were misdiagnosed as ectopic pregnancy,2 as follicular rupture,4 as corpus luteum rupture,2 as acute appendicitis.The postoperative pathology were confirmed as hemorrhagic salpingitis.Conclusion The clinical manifestations of hemorrhagic salpingitis is complex,according to intrauterine operation and infection history recently,intimate asking of menelipsis history,whether having body temperature increasing and white blood cells increasing,unclotting blood from posterior fornixwas puncture,combines with abnormal in B ultrasound and urine or blood-βHCG exam,the diagnosis often can be confirmed.Improving the understanding of hemorrhagic salpingitis,paying attention to the asking of history and mastering the diagnosis highlight are the key to reduce misdiagnosis.