绝经后宫腔积脓27例临床分析  

Analysis of Post-menopause Pyometra on 27 Patients

作　　者：李华 熊正爱[2] 

机构地区：[1]重庆江津区中心医院,402260 [2]重庆医科大学附属第二医院,404100

出　　处：《中国医药指南》2010年第29期22-24,共3页Guide of China Medicine

摘　　要：目的研究绝经后宫腔积脓的临床特点,提高对该病的诊断和治疗能力。方法回顾性分析近10年来收治的27例宫腔积脓患者的临床资料,包括症状、体征、辅助检查、治疗及结局,数据经过统计学处理。结果宫腔积脓患者高血压、血糖异常发病率与本地区一般老年人相比无差异性。2例无症状,2例表现为急性下腹痛和发热(占7.40%),但85.18%例有下腹坠胀或隐痛、81.48%例有阴道异常排液。血常规检查白细胞总数和(或)中性粒细胞增高12例(44.44%),B超全部有阳性发现。脓液细菌检测27例中16(59.26%)有例阳性发现。所有患者都行了脓液引流及诊断性刮宫,1例合并子宫内膜癌。4例发生了一过性寒颤、高热。置入一次性吸痰管并保留,脓液引流疗效满意。所有患者均治愈。1例3个月后复发,治愈。结论绝经后宫腔积脓患者临床表现为急腹症的少见,但多数有下腹坠胀或隐痛及阴道异常流液。诊断必须排除子宫内膜癌或宫颈癌,充分引流为主要治疗手段,注意宫腔操作时机,避免感染扩散。预后较好。Objective To evaluate the clinical characteristic of post-menopause pyometra.Method Retrospective study conducted between 2001and 2010 in A hospitals.Results Compared with the general elderly in this region,the incidence of glucose,hypertension have no difference.2 cases were asymptomatic.2（7.40%）cases presented acute lower abdominal pain and fever,23（85.18%）cases presented lower abdominal bulge or pain,22（81.48%）cases presented abnormal vaginal drain.Count of leucocyte and（or）neutrophil leucocyte raise up in 12case（44.44%）All cases had positive findings in B-ultrasound.Bacteria detection were positive in 16（59.26%）cases.All women were treated with dilatation of the cervix and drainage.and diagnostic curettage.One case had endometrial carcinoma.Transient shivering,high fever in 4 cases.In 10 serious cases,disposable suction tube placed into uterine cavity and maintained for a while.Effects of conducting were satisfied in all 10 cases.All cases were cured.1 case recurred 3 months later and cured.Conclusion In post-menopause pyometra.acute abdomen and high fever is infrequently,but most cases with symptoms such as lower abdominal bulge or pain,abnormal vaginal drain;Endometrial cancer or cervical cancer must be considered in differential diagnosis.Dilatation and drainage is the major treatment,.select correct opportunity to diagnostic curettage to avoid spreading of infection.In general,the outcome is better.

关 键 词：绝经 宫腔积脓 引流 

分 类 号：R711.74[医药卫生—妇产科学]