灭鼠药物中毒后黄体破裂1例并文献复习

A case of special corpus luteum rupture and literature review

目的探讨特殊黄体破裂临床特点,以提高诊治水平。方法对1例灭鼠剂中毒继发黄体破裂临床资料进行回顾,分析其临床特征、实验室及器械检查、治疗与转归并进行相关文献的复习。结果病人因“右侧腰腹部疼痛2 d”就诊,查凝血功能指标明显异常,B超及CT检查提示腹盆腔积液,左卵巢内异常回声,诊断黄体破裂,行剖腹探查术,术中见盆腔积血仅约500 mL,左卵巢黄体见约0.5 cm破裂口伴出血,行左卵巢黄体剔除+修补术,术后监测凝血指标仍反复异常,寻找原发病因为灭鼠剂中毒,予维生素K1连续治疗1周,病人各项指标逐渐恢复正常。结论黄体破裂临床表现及辅助检查不典型、术中所见与症状及体征严重不符、术后病情反复时,需警惕特殊原发病因存在可能,避免延误治疗。

Objective To explore the clinical characteristics of special corpus luteum rupture in order to improve the level of diagnosis and treatment.Methods The clinical data of a case of rodenticide poisoning secondary corpus luteum rupture was reviewed,and its clinical characteristics,laboratory and device inspection,treatment and outcome were analyzed,and relevant literatures were reviewed.Results The patient went to see a doctor for"right waist and abdomen pain for 2 days"and found that the coagulation function index was obviously abnormal.B-ultrasound and CT examination showed abdominal and pelvic effusion,abnormal echo in the left ova⁃ry,diagnosis of corpus luteum rupture,laparotomy.During the operation,pelvic hematocele was found to be only about 500mL,left ova⁃ry corpus luteum was found to be about 0.5cm rupture with hemorrhage,left ovary corpus luteum removal and repair was performed.After the operation,the coagulation index was still repeatedly abnormal,and the primary disease was found to be due to rodenticide poisoning.After continuous treatment with vitamin K1 for one week,all indexes of the patient gradually returned to normal.Conclusion When clinical manifestations and auxiliary examinations of corpus luteum rupture are atypical,what is seen during operation is seriously inconsistent with symptoms and signs,and the postoperative condition is repeated,it is necessary to guard against the possibility of special primary disease and avoid delaying treatment.