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目的研究中晚期妊娠合并非产科急腹症手术时机的选择。方法回顾分析26例中晚期妊娠合并非产科急腹症行急诊手术患者的临床资料。结果 26例中晚期妊娠合并非产科急腹症中,6例急性阑尾炎,4例子宫肌瘤变性伴出血,2例子宫感染,11例卵巢囊肿破裂,3例附件肿块扭转。子宫肌瘤变性伴出血于24 h后手术,子宫感染于48 h后手术;急性阑尾炎、卵巢囊肿破裂在6 h内手术。3例附件肿块扭转患者观察2~4天后进行手术,其余均在24 h内手术。6例剖腹探查同时进行剖宫产术,其他术后均保胎成功。结论不同病因的中晚期妊娠合并非产科急腹症临床特点不同,怀疑为急性阑尾炎、卵巢囊肿破裂及附件肿块扭转,应尽早手术;对于原因不明的腹痛,若估计胎儿已成熟,应积极行剖宫产终止妊娠同时行探查术。
Objective To study the timing of operation for non-obstetric acute abdomen in middle-late pregnancy. Methods Retrospective analysis of 26 cases of middle-late pregnancy combined with non-obstetric acute abdomen emergency surgery in patients with clinical data. Results 26 cases of non-obstetric acute abdomen in the second and third trimester of pregnancy, acute appendicitis in 6 cases, 4 cases of uterine fibroids degeneration with hemorrhage, 2 cases of uterine infection, 11 cases of ovarian cyst rupture, 3 cases of attachment mass reverse. Uterine fibroids degeneration with bleeding after surgery in 24 h, uterine infection after 48 h surgery; acute appendicitis, ovarian cyst rupture surgery within 6 h. Three cases of patients with tumor torsion observed 2 to 4 days after surgery, the rest were surgery within 24 h. 6 cases of laparotomy caesarean section at the same time, the other after the successful miscarriage. Conclusions The clinical features of non-obstetric emergent abdomen with different etiologies are different in clinical features. Suspected to be acute appendicitis, ruptured ovarian cysts and torsion of appendages should be treated as soon as possible. For unexplained abdominal pain, if it is estimated that the fetus is mature, it should be actively performed Palace termination of pregnancy while exploration.