68例妇科急腹症患者误诊为急性阑尾炎的临床分析

Clinical analysis of 68 cases of gynecologic acute abdomen misdiagnosed as acute appendicitis

目的:探讨妇科急腹症患者误诊为急性阑尾炎的原因及诊断鉴别。方法:选取急性阑尾炎患者76例作为对照组;将被误诊的68例妇科急腹症患者作为观察组。统计较为常见的被误诊的妇科疾病种类,比较两组患者的年龄、婚姻状况、有无典型症状、血象变化及妇科病史等情况,从而深入分析误诊原因。结果:较为常见的被误诊的妇科疾病种类包括异位妊娠、右输卵管囊肿以及盆腔炎;观察组患者的已婚率及妇科病史率显著高于对照组(P<0.05);对照组患者的转移性右下腹痛的比例高于观察组(P<0.05)。另外53例患者可以判定误诊原因,包括21例查体不仔细,17例病史询问不仔细,15例两者均有。结论:妇科急腹症与急性阑尾炎临床表现诸多不同,误诊属接诊和鉴别诊断不到位。

Objective:To study reasons of gynecological acute abdomen misdiagnosed as acute appendicitis and its diagnosis and identification. Methods:76 cases with acute appendicitis were chosen as control group, and 68 cases of gynecological acute abdo-men misdiagnosed as acute appendicitis were used as observation group. The patient age, marital status, presence or absence of typical symptoms, changes in blood and gynecological history of the two groups were compared in order to analyze the causes of misdiagnosis. Results:The common misdiagnosed gynecological diseases included ectopic pregnancy, right oviduct cyst and pelvic inflammatory dis-ease. The married rate as well as the gynecological history rate of observation group were significantly higher than those of control group (P<0. 05). The metastatic right lower abdominal pain rate was higher than that of observation group (P>0. 05). The misdiagnosis reasons could be determined for 53 cases, wherein 21 cases of careless body examination, 17 cases of careless history talking, and 15 cases of both. Conclusions:The gynecologic acute abdomen with acute appendicitis exist difference, and inappropriate reception and identification can lead to to misdiagnosis.