本文選題：妊娠 + 急腹癥��； 參考：《大連醫(yī)科大學(xué)》2013年碩士論文

【摘要】：急腹癥是以急性腹痛為主要表現(xiàn)，需要早期診斷和及時處理的腹部疾病。妊娠合并急腹癥，具有起病急，進(jìn)展快、臨床表現(xiàn)復(fù)雜多樣、涉及病種繁多的特點(diǎn)，易導(dǎo)致誤診、漏診，一旦延誤治療，將嚴(yán)重威脅母嬰的健康。早期識別和正確的處理妊娠期急腹癥，對改善母嬰的預(yù)后有著極其重要意義。因此，總結(jié)和分析妊娠合并急腹癥的臨床特征和治療方法，有利于在今后臨床工作中減少失誤，提高診斷和救治水平。 目的：討論妊娠合并急腹癥的臨床特點(diǎn)和處理方法，提高妊娠期急腹癥的診斷和治療水平。 方法：收集2006年5月～2012年12月經(jīng)大連醫(yī)科大學(xué)附屬第一醫(yī)院收治的45例妊娠合并急腹癥患者的臨床資料，進(jìn)行回顧性分析。 結(jié)果：妊娠合并急腹癥45例中，急性闌尾炎23例（51.11%）;急性胃腸炎10例（22.22%）；急性膽囊炎3例（6.67%）;急性胰腺炎4例（8.89%）;腸梗阻3例（6.67%）；腸穿孔1例（2.22%）；卵巢膿腫1例（2.22%）。手術(shù)治療18例（40.00%）；保守治療27例（60.00%）。早產(chǎn)4例（8.89%）；流產(chǎn)3例，其中2例為家屬要求終止妊娠（6.67%）。誤診3例，其中闌尾炎誤診1例（25+6W），，腸穿孔誤診1例（35+4W），卵巢膿腫誤診1例（38+6W），誤診患者平均年齡25歲，誤診率為6.67%。 結(jié)論：妊娠急腹癥因其特殊的解剖、生理變化，容易出現(xiàn)診斷困難，需要產(chǎn)科醫(yī)師和內(nèi)、外科及相關(guān)科室密切合作、提高意識、共同參與，以減少誤診，使患者得到積極合理的治療。處理妊娠合并急腹癥時，不應(yīng)因妊娠而改變手術(shù)指征，但需兼顧孕婦和胎兒的安全，合理的手術(shù)治療不會增加流產(chǎn)、早產(chǎn)及胎兒損失。
[Abstract]:Acute abdomen is an abdominal disease characterized by acute abdominal pain, which needs early diagnosis and timely treatment. Pregnancy complicated with acute abdomen, with rapid onset, rapid progress, complicated and diverse clinical manifestations, involving a wide variety of disease characteristics, easy to lead to misdiagnosis, missed diagnosis, once delayed treatment, will seriously threaten the health of mother and child. Early identification and correct treatment of acute abdominal syndrome in pregnancy are of great significance to improve the prognosis of mother and child. Therefore, summing up and analyzing the clinical characteristics and treatment methods of pregnancy with acute abdomen is helpful to reduce errors and improve the level of diagnosis and treatment in the future clinical work. Objective: to discuss the clinical features and management of pregnancy complicated with acute abdomen, and to improve the diagnosis and treatment of pregnancy acute abdomen. Methods: the clinical data of 45 cases of pregnancy complicated with acute abdomen admitted from the first affiliated Hospital of Dalian Medical University from May 2006 to December 2012 were retrospectively analyzed. Results: of the 45 cases of acute abdomen, 23 cases were acute appendicitis, 10 cases were acute gastroenteritis, 3 cases were acute cholecystitis, 3 cases were acute cholecystitis, 4 cases were acute pancreatitis, 4 cases were acute pancreatitis, 3 cases were intestinal obstruction, 1 case was intestinal perforation, 1 case was intestinal perforation, and 1 case was ovarian abscess. Surgical treatment was performed in 18 cases, and conservative treatment in 27 cases. There were 4 cases of premature delivery and 3 cases of miscarriage, of which 2 cases were requested by family members to terminate pregnancy. 3 cases were misdiagnosed, including appendicitis misdiagnosed in 1 case, intestinal perforation misdiagnosed in 1 case, ovarian abscess misdiagnosed in 1 case, the average age of misdiagnosed patients was 25 years old, the misdiagnosis rate was 6.67%. Conclusion: because of its special anatomical and physiological changes, the acute abdomen of pregnancy is easy to be diagnosed. It needs close cooperation between obstetricians and internal, surgical and related departments to raise awareness and participate in order to reduce misdiagnosis. Make the patient get positive and reasonable treatment. The surgical indication should not be changed because of pregnancy, but the safety of pregnant woman and fetus should be taken into account. Reasonable surgical treatment will not increase abortion, premature delivery and fetal loss.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R714.25

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本文編號：1936229