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目的了解妇科常见急腹症的临床特征以减少误诊。方法对2007-12-2009-12武汉市第七医院妇产科收治的122例腹痛患者进行分析。结果盆腔炎48例(39.34%)有多次流产史或生育史伴发热白带异常,B超示盆腔积液附件囊性包块,异位妊娠56例(45.90%)有停经史阴道不规则流血尿HCG阳性,B超示盆腔积液附件混合性包块甚至胎心搏动,黄体破裂7例(5.74%)发生在月经中后期B超示盆腔积液附件包块,卵巢囊肿蒂扭转5例(4.10%)有附件包块病史B超示附件包块回声不均,子宫穿孔2例(1.64%)均有宫腔操作史,浆膜下肌瘤蒂扭转2例(1.64%)B超示盆腔包块,急性阑尾炎2例(1.64%)有转移性右下腹痛病史麦氏点压痛反跳痛伴血象高。结论诊断时应重视病史的采集,尤其是月经史是否有不洁性生活史或宫腔手术史,注重临床体征,影像学检查是一种重要的辅助诊断方法。
Objective To understand the clinical features of gynecological common acute abdomen to reduce misdiagnosis. Methods A total of 122 patients with abdominal pain were admitted to Department of Obstetrics and Gynecology, Seventh Hospital of Wuhan University from December 2007 to December 2009. Results 48 cases of pelvic inflammatory disease (39.34%) had multiple miscarriage history or history of vaginal discharge with fever, B ultrasound showed pelvic effusion cystic mass, ectopic pregnancy in 56 cases (45.90%) had vaginal discharge vaginal irregular flow Hematuria HCG positive, B ultrasound showed pelvic fluid attachments mixed mass or even fetal heart beat, corpus luteum rupture in 7 cases (5.74%) occurred in the late menstruation B ultrasound pelvic fluid annex mass, ovarian cyst torsion in 5 cases ( 4.10%) had a history of Annex mass of the B-annex showed uneven echo mass, uterine perforation in 2 cases (1.64%) had a history of uterine operation, subserosal fibroids pedicle torsion in 2 cases (1.64% Mass, acute appendicitis in 2 cases (1.64%) had a history of metastatic right lower quadrant abdominal pain and rebound tenderness with high blood count. Conclusion The diagnosis should pay attention to the collection of medical history, especially whether there is history of menstrual history of dirty or intrauterine surgery history, pay attention to clinical signs, imaging is an important diagnostic method.