女性盆腔脓肿56例临床分析

Clinical analysis of 56 cases of pelvic abscess

目的探讨女性盆腔脓肿的临床特点、辅助检查结果及最佳治疗方法。方法回顾性分析2011年1月至2021年4月在中国科学技术大学附属第一医院妇科收治的盆腔脓肿手术患者56例,对其基本资料、既往史,临床症状、实验室检查、B超检查、术前诊断及手术等方面进行分析,其中19例是非手术组,37例是手术组。比较两组患者的治疗有效率,同时分析比较开腹手术组和腹腔镜手术组的手术时间、术中出血量及住院时间。结果盆腔脓肿临床表现多样,患者常以腹痛、发热、消化道症状入院。患者实验室检查白细胞总数[(12.74±3.93)×10^(9)/L]、血红蛋白[(106.14±15.13)g/L]、C反应蛋白[(129.91±70.24)mg/L]、降钙素原[(0.45±0.76)ng/mL]、糖类抗原125[(107.85±85.75)u/mL]存在明显变化。脓液培养多为大肠埃希菌,B超影像多变且缺乏特异性,非手术组和手术组的临床有效率分别为79%和100%,两组差异有统计学意义(P<0.05)。开腹手术组及腔镜手术组的手术时间、术中出血量、住院时间相比较,差异有统计学意义(P<0.05)。结论盆腔脓肿诊断需结合B超,既往史及辅助检查,提高确诊率;腹腔镜手术治疗盆腔脓肿创伤小、出血少、住院时间段,恢复快。

Objective To investigate the clinical characteristics,auxiliary examination results and best treatment of pelvic abscess.Methods Fifty six cases of pelvic abscess treated by surgery from January 2011 to April 2021 in the department of gynaecology of the First Affiliated Hospital of University of Science and Technology of China were analyzed respectively,the basic information,past medical history,clinical symptoms,laboratory examination,B ultrasonic examination,preoperative diagnosis and surgery were analyzed,including 19 cases in non-operation group surgery,37 cases in operation group.The treatment efficiency of the two groups was compared,and the operation time,intra operative blood loss and hospital stay of the open surgery group and the laparoscopic surgery group were analyzed and compared.Results The clinical manifestations of pelvic abscess were varied,and the patients were often admitted with abdominal pain,fever and digestive tract symptoms.The total number of white blood cells was[(12.74±3.93)×10^(9)/L],hemoglobin[(106.14±15.13)g/L],C-reactive protein[(129.91±70.24)mg/L],procalcitonin[(0.45±0.76)ng/mL],carbohydrate antigen 125[(107.85±85.75)u/mL]changed significantly.The pustules culture was mostly Escherichia coli,and the B-ultrasound images were varied and lack of specificity.The clinical effective rate of the non-operation group and the operation group were 79%and 100%respectively,and the difference between the two groups was statistically significant(P<0.05).There were significant differences in operative time,intra operative blood loss and hospital stay between the open surgery group and the endoscopic surgery group(P<0.05).Conclusions The diagnosis of pelvic abscess should be combined with B ultrasonography,past history and auxiliary examination to improve the diagnostic rate.Laparoscopic surgery in the treatment of pelvic abscess has the advantages of less trauma,less bleeding,quick recovery during hospitalization.