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目的探讨宫腔积脓的发病原因、诊断及治疗方法。方法分析高淳县人民医院11例宫腔积脓女性患者,对其发病特点、诊治方法进行分析、总结。结果所有病例均为绝经后期。1例以急性腹膜炎外科急诊手术,1例经抗炎治疗后效果不佳急诊手术(2例术中发现均为宫颈癌并发宫腔积脓子宫穿孔),上述2例及另2例患者均行全子宫双附件切除。1例系宫颈癌全量放疗后并发宫腔积脓转上级医院,其余6例患者行分段诊段性刮宫并结合低负压吸引,3例行宫腔灌洗及引流治疗。所有病例均配合抗生素治疗,除转诊者均控制感染后出院,随访无宫腔积脓复发或继发盆腔脓肿。结论绝经后妇女宫腔积脓发病隐匿,有时合并妇科恶性肿瘤,易误诊,经阴道超声检查及分段诊刮对本病的诊断有重要价值,使用广谱抗生素加抗厌氧菌治疗,结合低负压吸引及宫腔灌洗引流对该病有明显疗效。
Objective To investigate the causes of empyema empyema, diagnosis and treatment. Methods 11 cases of female patients with uterine empyema in Gaochun People ’s Hospital were analyzed and their characteristics of onset, diagnosis and treatment were analyzed and summarized. Results All cases were postmenopausal. 1 case of acute peritonitis surgery emergency surgery, 1 case of poor response after anti-inflammatory treatment of emergency surgery (2 cases of intraoperative findings were cervical uterine empyema uterine perforation), the 2 cases and 2 patients underwent Full hysterectomy double attachment removal. One case of cervical cancer after full dose of radiotherapy and uterine empyema to the higher hospital, the remaining 6 patients underwent segmental diagnostic curettage and low suction to attract, 3 cases of uterine cavity lavage and drainage. All cases were treated with antibiotics, except those who were transferred after infection control were discharged, no recurrence of uterine empyema or secondary pelvic abscess. Conclusions The pathogenesis of uterine empyema in the postmenopausal women is occult, sometimes combined with gynecological malignancies. Misdiagnosis, transvaginal ultrasonography and sectional curettage are of great value in the diagnosis of this disease. The use of broad-spectrum antibiotics and anti-anaerobic bacteria combined with low negative pressure Attraction and drainage of the uterine cavity has a significant effect on the disease.