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目的:分析宫腔积脓并发子宫穿孔的临床特点、误诊原因,提高对宫腔积脓并发子宫穿孔的认识,增强防治意识。方法:报道1例宫腔积脓并发子宫穿孔,并结合国内文献报道的35例宫腔积脓并发子宫穿孔患者临床资料进行分析。结果:35例全部发生于绝经后女性,症状重,病程短,均有进行性全腹痛及弥漫性腹膜炎的症状体征,误诊率极高。35例患者中误诊病例32例,占91.43%,确诊病例3例,占8.57%。2例死亡,1例子宫内膜癌术后放弃治疗,32例痊愈。结论:宫腔积脓并发子宫穿孔主要发生于绝经后女性,及时治疗预后较好,应当重视绝经后妇女保健。
Objective: To analyze the clinical characteristics of uterine empyema complicated with uterine perforation, misdiagnosis reasons, to improve uterine cavity empyema complicated uterine perforation awareness and enhance awareness of prevention and treatment. Methods: One case of uterine empyema complicated with uterine perforation was reported, and the clinical data of 35 cases with uterine empyema complicated with uterine perforation reported in the domestic literature were analyzed. Results: All the 35 cases occurred in postmenopausal women with severe symptoms and short course of disease. All of them had symptoms and signs of progressive total abdominal pain and diffuse peritonitis with a high misdiagnosis rate. Among the 35 cases, 32 cases were misdiagnosed, accounting for 91.43%. Three cases were diagnosed, accounting for 8.57%. 2 died, 1 case of endometrial cancer to give up after treatment, 32 cases recovered. Conclusions: Hysteric empyema complicated with uterine perforation mainly occurs in postmenopausal women, and the prognosis of timely treatment is good. Therefore, we should pay attention to the health care of postmenopausal women.