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近二年来,我科对输卵管结扎术后长期腹痛的14例患者进行了观察治疗及剖腹探查术,查明了原因,并作了相应处理,取得较满意效果,小结如下。临床资料本组30岁以下2例,31～40岁9例,41岁以上3例。生育3胎以上9例,2胎4例,1胎1例。14例均在基层医院行腹式小切口近端包埋法输卵管结扎术,其中产后结扎2例,哺乳期结扎4例,月经前结扎4例,月经后结扎4例。14例中有5例手术时间较长,但术后伤口均Ⅰ期愈合。5例术后有发热史。本组术后1个月内发病6例,2～6个月发病4例,半年以上发病4例。14例均有长期下腹痛,有的伴阵发性加剧,多在月经期或劳累后加重,还有6例伴有月经异常。本组有4例子宫增大如孕6～8周,3例两侧附件扪及包块,4例单侧附件扪及包块,3例子宫活动受限,附件增厚有触痛。14例全部作过B 超检查,其中4例发现子宫肌瘤,3例有附件液性包块。8例做过胃肠透视,其中2例发现有十二指肠憩室,3例阑尾内有粪石。2例做过纤维胃镜检查,均诊断为胃、十二指肠炎。1例在院外做过腹腔镜检查,诊断为盆
In the past two years, our department has observed and treated 14 cases of long-term abdominal pain after tubal ligation and laparotomy, identified the causes, and made the appropriate treatment to obtain more satisfactory results, the summary is as follows. Clinical data The group of 30 patients under the age of 2 cases, 31 to 40 years old in 9 cases, 41 years of age in 3 cases. 3 childbirth more than 9 cases, 2 tires in 4 cases, 1 child in 1 case. All the 14 cases underwent proximal tubal ligation of the abdominal incision in the primary hospital. There were 2 cases of postpartum ligation, 4 cases of lactation, 4 cases of premenstrual ligation and 4 cases of ligation after menstruation. Five of the 14 patients had a longer operative period, but all the wounds healed in the first period. 5 patients had fever history. The group within 1 month after onset in 6 cases, 2 to 6 months in 4 cases, more than six months the incidence of 4 cases. 14 cases had long-term lower abdominal pain, some accompanied by paroxysmal exacerbations, and more in the menstrual period or after exertion increased, there are 6 cases with menstrual abnormalities. This group had 4 cases of uterine enlargement, such as pregnancy 6 to 8 weeks, 3 cases of palpable mass on both sides of the annex, 4 cases of unilateral palpable mass, 3 cases of uterine motion restriction, attachment thickening tenderness. All 14 patients underwent B-mode ultrasound examination. Among them, 4 cases had uterine fibroids and 3 cases had liquid lumps. 8 cases had done gastrointestinal fluoroscopy, of which 2 cases found to have duodenal diverticulum, 3 cases of fecal stone in the appendix. 2 cases done fiber endoscopy, were diagnosed with stomach, duodenitis. One patient had a laparoscopy outside the hospital and was diagnosed as a basin