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目的观察分析宫颈管粘连误诊为急性阑尾炎病例诊断及处理方法,总结其临床诊治经验教训和临床意义。方法选取我院2012年3月收治的1例宫颈管粘连误诊为急性阑尾炎的患者,对其临床病历资料进行回顾性分析。结果 1例宫颈管粘连误诊为急性阑尾炎的患者,初诊为急性阑尾炎,行手术探查中无发现阑尾及肠管异常,结合患者人流病史综合分析后,立即在B超引导下行宫颈扩张术,术中可见大量的暗红色陈旧性积血从宫腔流出,约有500ml,确诊为宫颈管粘连,治愈出院,术后无感染并发症发生,术后随访6个月,无再次粘连发生。结论临床医生由于对宫颈管粘连的认识不足或重视度不够,容易发生误诊为急性阑尾炎,对于此类患者,初诊时应自行询问病史,尤其是人流史和月经史,以早期排除诊断,并充分结合其临床表现特征、实验室检查结果、体格检查等进行综合分析,对疑似病例可给予探针探查宫腔,同时起到确诊与治疗的效果。
Objective To observe and analyze the diagnosis and treatment of misdiagnosis of cervical canal adhesions as acute appendicitis and to summarize the experiences and lessons of clinical diagnosis and treatment and clinical significance. Methods A case of misdiagnosis of cervical adhesions as acute appendicitis in our hospital in March 2012 was retrospectively analyzed. Results One patient with misdiagnosed as cervical appendicitis was acute appendicitis. No appendiceal and intestinal abnormalities were found during surgical exploration. Combined with the history of flow of patients, cervical dilation was performed immediately under B-mode ultrasound. A large number of dark red old blood from the uterine outflow, about 500ml, diagnosed with cervical adhesions, cured and discharged without postoperative complications of infection occurred, after 6 months of follow-up, no adhesions occurred. Conclusion Clinicians due to lack of understanding of the cervical canal adhesions or inadequate attention, prone to misdiagnosed as acute appendicitis, such patients should be asked when the first visit to the history of medical history, especially the history of abortion and menstruation to early rule out the diagnosis and adequate Combined with its clinical manifestations, laboratory tests, physical examination and other comprehensive analysis of suspected cases can be given probes to probe the uterine cavity, at the same time play the role of diagnosis and treatment.