临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2015年
4期
49-51
,共3页
妊娠%阑尾炎%误诊%早孕%胃肠炎
妊娠%闌尾炎%誤診%早孕%胃腸炎
임신%란미염%오진%조잉%위장염
Pregnancy%Appendicitis%Diagnostic error%Treatment%Gastroenteritis
目的:探讨妊娠期急性阑尾炎的诊断要点与治疗原则,以保障母婴安全。方法回顾分析32例妊娠期急性阑尾炎的临床资料。结果本组早期妊娠6例、中晚期妊娠26例,表现为转移性右下腹痛26例、单纯右下腹痛6例,部分伴恶心、呕吐、发热。7例病程早期误诊为早孕反应4例、急性胃肠炎3例,误诊率21.9%。均经查体、B超或手术病理诊断确诊。本组手术治疗30例术后痊愈,其中2例行人工流产,1例自然流产,27例至孕足月顺利分娩,胎儿无异常;2例予保守治疗症状缓解,1例复发。结论仔细查体、甄别症状并及时行B超检查是提高妊娠期急性阑尾炎确诊率的关键;一旦确诊应积极行手术治疗,以保障母婴安全。
目的:探討妊娠期急性闌尾炎的診斷要點與治療原則,以保障母嬰安全。方法迴顧分析32例妊娠期急性闌尾炎的臨床資料。結果本組早期妊娠6例、中晚期妊娠26例,錶現為轉移性右下腹痛26例、單純右下腹痛6例,部分伴噁心、嘔吐、髮熱。7例病程早期誤診為早孕反應4例、急性胃腸炎3例,誤診率21.9%。均經查體、B超或手術病理診斷確診。本組手術治療30例術後痊愈,其中2例行人工流產,1例自然流產,27例至孕足月順利分娩,胎兒無異常;2例予保守治療癥狀緩解,1例複髮。結論仔細查體、甄彆癥狀併及時行B超檢查是提高妊娠期急性闌尾炎確診率的關鍵;一旦確診應積極行手術治療,以保障母嬰安全。
목적:탐토임신기급성란미염적진단요점여치료원칙,이보장모영안전。방법회고분석32례임신기급성란미염적림상자료。결과본조조기임신6례、중만기임신26례,표현위전이성우하복통26례、단순우하복통6례,부분반악심、구토、발열。7례병정조기오진위조잉반응4례、급성위장염3례,오진솔21.9%。균경사체、B초혹수술병리진단학진。본조수술치료30례술후전유,기중2례행인공유산,1례자연유산,27례지잉족월순리분면,태인무이상;2례여보수치료증상완해,1례복발。결론자세사체、견별증상병급시행B초검사시제고임신기급성란미염학진솔적관건;일단학진응적겁행수술치료,이보장모영안전。
Objective To explore the key points of the diagnosis of acute appendicitis during pregnancy and treatment principle, to ensure the safety of the mother and the infant. Methods Retrospective analysis of the clinical data of 32 cases of pregnancy with acute appendicitis was conducted. Results In the group, there were 6 cases of early pregnancy and 26 cases of middle-late pregnancy, characterized by metastatic right lower quadrant abdominal pain in 26 cases, by right quadrant lower abdominal pain in 6 cases, some of them with nausea, vomiting and fever. 3 cases were misdiagnosed as early pregnancy reac-tion, 34 cases were misdiagnosed as acute gastroenteritis. The 7 initially misdiagnosed cases were 4 cases of early pregnant re-action and 3 cases of AGE and the misdiagnosis rate was 21. 9%. All of them were confirmed with diagnosis by physical exam-ination, ultrasound or surgical pathology. 30 cases of this group had postoperative recovery. 2 cases had abortion, 1 case had spontaneous abortion, 27 cases delivered the birth of full-term pregnancy, and the fetus were normal. 2 cases improved after conservative treatment, 1 case had relapse. Conclusion Careful physical examination, timely identification of symptoms and B ultrasonic examination are essential to improve the diagnosis rate of acute appendicitis during pregnancy;and once diagnosis is made, active surgical treatment is necessary to ensure the safety of the mother and the infant.