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目的:探讨妇科常见急腹症的诊断、误诊原因。方法:对我院1995-01/2007-12间阑尾手术的398例临床资料复习,因妇科急腹症而误诊为急性阑尾炎的23例作回顾性分析。结果:误诊率占5.8%,被误诊的妇科病有异位妊娠破裂13例,卵巢囊肿蒂扭转4例,卵巢囊肿破裂1例,卵泡或黄体破裂2例,化脓性附件炎2例,子宫穿孔1例。结论:发生于右侧的妇科急腹症与急性阑尾炎极易混淆而误诊,要正确地诊断应详细采集病史,非妇科医生应提高对妇科病的认识,并选做相应的检查(B超、腹穿、后穹窿穿刺等)。
Objective: To investigate the diagnosis and misdiagnosis of gynecological common acute abdomen. Methods: The clinical data of 398 cases of appendix surgery in our hospital from January 1995 to December 2007 were reviewed retrospectively. Twenty-three cases were misdiagnosed as acute appendicitis due to gynecologic acute abdomen. Results: The misdiagnosis rate was 5.8%. The misdiagnosed gynecological diseases were ectopic pregnancy rupture in 13 cases, ovarian cyst torsion in 4 cases, ovarian cyst rupture in 1 case, follicular or corpus luteum rupture in 2 cases, purulent annexitis in 2 cases, uterine perforation 1 case. Conclusions: The gynecologic acute abdomen appearing on the right and the acute appendicitis can easily be confused and misdiagnosed. To correctly diagnose, the medical history should be collected in detail. Non-gynecologists should raise awareness of gynecological diseases and choose the corresponding examination (B- Abdominal wear, culdocentesis, etc.).