盆腔脓肿64例的临床诊断与治疗方案探讨

Study on clinical diagnosis and therapeutic regimen in 64 cases of pelvic abscess

目的探讨盆腔脓肿的诊断方法及治疗的优选方案。方法回顾性分析2008年10月至2011年10月期间收治的64例确诊为盆腔脓肿患者的临床资料,研究组为腹腔镜手术联合抗生素治疗的病例30例,对照组为单纯进行抗生素治疗的病例34例,比较两组的病症状好转时间、住院时间、术后并发症情况及远期疗效。结果研究组在平均住院时间、肿块消退率、CA125降低时间、症状好转时间方面均优于对照组(P<0.05)。远期月经紊乱、痛经和盆腔痛的发生率研究组也明显低于对照组(P<0.05)。结论盆腔脓肿的临床误诊率高,需结合患者症状及体征、实验室检查、B超检查等做出正确、有效的诊断;应用腹腔镜手术加抗生素治疗盆腔脓肿,安全可靠,近、远期疗效均优于单纯使用抗生素治疗,是治疗盆腔脓肿的优选方案。

Objective To explore the diagnosis of pelvic abscess and to study the preferred therapeutic regimen for pelvic abscess.Methods The clinical data of 64 cases diagnosed as pelvic abscess admitted in this department from October 2008 to October 2011 were retrospectively analyzed.Among them,30 cases in study group were treated by laparoscopic surgery and antibiotic therapy,and 34 cases in control group were treated only with antibiotic therapy,and duration for remission of symptoms,length of hospitalization and postoperative complications were compared between these 2 groups.Results There was significant difference（P0.05） in average length of hospitalization,regression rate of encapsulated tumor,time for decrease of CA 125 and time for remission of symptoms between these 2 groups.Patients in study group had better comprehensive effect than that of control group.Conclusion There is a high rate in misdiagnosis of pelvic abscess,physicians should combine the symptoms and signs of patients with laboratory examinations and B type ultrasonic imaging to make a correct and effective diagnosis.The application of laparoscopic surgery in treatment of pelvic abscess is safe and reliable,and it has better efficacy than simple application of antibiotic therapy,and it is a preferred therapeutic method for pelvic abscess.