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目的:探讨妇女宫腔积脓的病因、诊断、治疗及预防。方法:回顾分析哈尔滨医科大学附属第二医院收治的37例宫腔积脓患者的病史、临床表现、辅助检查及诊治情况。结果:宫腔积脓以绝经后老年女性多见,未绝经患者多合并严重的阴道炎症、子宫内膜炎等。37例患者中,手术患者13例,其中合并穿孔感染性腹膜炎及感染性休克患者1例,1例患者术后诊断为宫颈癌,术前诊断明确的子宫恶性肿瘤患者7例,引流失败行全子宫切除3例,子宫脱垂患者1例。宫腔镜及超声引导下置管引流成功10例,宫腔镜下冲洗14例。37例患者均进行对症抗感染治疗,除恶性肿瘤患者,其余均已治愈。结论:宫腔积脓在临床上并不多见,症状不典型,易误诊,可引起严重并发症,应针对病因早期诊断、早期治疗。
Objective: To investigate the etiology, diagnosis, treatment and prevention of empyema in women. Methods: Retrospective analysis of the Harbin Medical University Second Affiliated Hospital of 37 patients with empyema empyema history, clinical manifestations, laboratory examinations and diagnosis and treatment. Results: Uterine empyema in the elderly more common in postmenopausal women, not too many patients with severe vaginal inflammation, endometritis and so on. Thirty-seven patients were operated on in 13 patients, including 1 patient with peritonitis and septic shock complicated by peritonitis, 1 patient diagnosed as cervical cancer, 7 patients with preoperative diagnosis of uterine malignant tumor, 3 cases of hysterectomy, 1 case of uterine prolapse. Hysteroscopy and ultrasound guided catheter drainage in 10 cases, 14 cases of hysteroscopic irrigation. 37 patients were symptomatic and anti-infective treatment, in addition to malignant tumor patients, the rest have been cured. Conclusions: Uterine empyema is rare in clinic, the symptoms are not typical, easily misdiagnosed, can cause serious complications, should be for the early diagnosis of disease, early treatment.