本文選題：盆腔膿腫 + 重癥感染　； 參考：《現(xiàn)代婦產(chǎn)科進展》2017年12期

【摘要】：目的:探討婦科重癥感染的臨床表現(xiàn)及診治經(jīng)驗。方法:回顧分析2000年1月至2016年9月于北京協(xié)和醫(yī)院就診的8例婦科重癥感染病例資料并復(fù)習(xí)相關(guān)文獻。結(jié)果:8例患者臨床表現(xiàn)以發(fā)熱、腹痛、盆腔包塊為主,4例(50.0%)出現(xiàn)感染性休克,4例(50.0%)感染病灶累及腸道。急診手術(shù)6例(75.0%),囊腫剔除及膿腫引流2例,患側(cè)附件切除3例,全子宮患/雙側(cè)附件切除3例。術(shù)后1例切口感染,1例發(fā)生小腸穿孔、應(yīng)激性心肌病,1例肺栓塞。隨診率87.5%(7/8),隨診2~74個月,1例術(shù)后8個月盆腔炎復(fù)發(fā),保守治療好轉(zhuǎn)。結(jié)論:盆腔膿腫延誤診治及膿腫破裂可引起嚴(yán)重并發(fā)癥,應(yīng)及時手術(shù)干預(yù)。婦科重癥感染患者多合并子宮內(nèi)膜異位癥,感染病灶易累及腸道,需多科合作。術(shù)后并發(fā)癥兇險,圍手術(shù)期嚴(yán)密監(jiān)護十分重要。
[Abstract]:Objective: to investigate the clinical manifestation, diagnosis and treatment of severe gynecological infection. Methods: the data of 8 cases of severe gynecological infection from January 2000 to September 2016 in Beijing Union Hospital were retrospectively analyzed and the related literatures were reviewed. Results the clinical manifestations of 8 cases were fever, abdominal pain, pelvic mass in 4 cases (50.0%), septic shock in 4 cases (50.0%) and intestinal involvement in 4 cases (50.0%). Emergency surgery was performed in 6 cases (75.0%), cyst excision and abscess drainage in 2 cases, appendectomy in 3 cases, and total hysterectomy / bilateral appendectomy in 3 cases. Postoperative incision infection occurred in 1 case with small bowel perforation and stress cardiomyopathy in 1 case with pulmonary embolism. The follow-up rate was 87.5% (7 / 8). One case of pelvic inflammation recurred from 2 to 74 months after operation and the conservative treatment was improved. Conclusion: the delayed diagnosis and treatment of pelvic abscess and rupture of abscess may cause serious complications. Gynecological patients with severe infection are more complicated with endometriosis. Postoperative complications are dangerous, perioperative close monitoring is very important.
【作者單位】： 中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)院婦產(chǎn)科;
【分類號】：R711

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