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。%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.
展开▼
