妇科急腹症1684例临床分析

Analysis of 1684 Cases of gynecologic emergencies

目的 :提高临床医师对妇科急腹症的诊断和治疗水平。方法 :对我院 1 986年 1 2月至 2 0 0 2年1 2月以妇科急腹症就诊的 1 684例患者临床资料进行回顾性分析。结果 :1 684例病人包括1 2个病种 ,分为四大类 :感染性疾病 ( 4 5 .7% ) ,腹腔内出血性疾病 ( 4 4.5 % ) ,肿瘤并发症 ( 5 .3% ) ,非妇科疾病 ( 4 .5 % )。妇科疾病中保守性治疗 90 8例 ,占 5 5 .2 % ,多为感染性疾病 ;手术治疗 72 1例 ,占 44.8% ,多为内出血性疾病和肿瘤并发症 ,其中腹腔镜手术 34例。结论 :详细病史询问及体格检查是诊断妇科急腹症的重要手段 ;HCG检查 ,后穹隆穿刺及腹腔镜检查可明显提高确诊率 ;腹腔镜手术较传统手术有较多的优点 。

Objective: To improve the standard of diagnosing and treating gynecologic abdominal emergencies. Methods: We analyzed retrospectively 1684 cases of gynecologic emergencies in our hospital from Dec. 1986 to Dec.2002. Results:There were 12 diseases in these 1684 cases. The diseases can be divided into 4 kinds of diseases. They included infection diseases, internal bleeding diseases, tumours and their complications and non-gynecologic diseases. Among gynecologic diseases 908 cases were treated with non-operational methods(55.2%). Most of them were infective diseases. 21 cases were treated with operational method(44.8%). Most of them were internal bleeding and tumours and their complications. 34 cases were treated with laparoscopy. Conclusion: Inquiring history and careful physical examination are very important methods of diagnosing gynecology emergencies. Testing HCG, culdocentesis laparoscopy can improve the correct diagnosis rate significantly. Laparoscopy has many advantages over traditional operations. The indications of laparoscopy should be extended.