化脓性盆腔炎(盆腔脓肿)25例临床分析  

Analysis of pelvic abscess with 25 cases

作　　者：张瑞[1] 陈施[1] 刘朝晖[1] ZHANG Rui, CHEN Shi, LIU Zhaohui.(Department of Obstetrics and Gynecology, Peking university first Hospital, Beijing 100044, Chin)

机构地区：[1]北京大学第一医院妇产科

出　　处：《中国妇产科临床杂志》2018年第3期226-228,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：国家自然科学基金(81471420);教育部博士学科点基金(20130001120051)

摘　　要：目的探讨脓肿穿刺引流术在化脓性盆腔炎治疗中的价值。方法回顾性分析2011年10月至2016年8月在北京大学第一医院就诊的化脓性盆腔炎患者，对比单纯抗生素治疗、腹腔镜手术和穿刺引流术三种治疗方法的优劣性。结果共25例患者符合入排标准，所有患者均有盆腔炎引起的发热、血象升高等全身表现。其中4例有PID病史，3例患者因盆腔炎急性发作急诊人院，5例近期有盆腹腔手术史。与抗生素＋腹腔镜相比，单纯使用抗生素组的治疗时间、症状好转所需时间较长，所有患者均临床缓解，而60％的患者复发需要再次住院治疗。穿刺引流组患者的病程、住院时间、症状缓解所需时间及血象等指标好转所需时间均与腹腔镜组无明显差别。腹腔镜组，所有患者均能临床治愈。穿刺引流组50％的患者临床缓解，其中37．5％的患者因复发需要再次人院治疗。结论穿刺引流术是有效治疗化脓性盆腔炎的方法之一，尤其适用于病情复杂、手术难度高等不宜手术的患者。Objective To evaluate the effect of drainage to treat pelvic abscess. Methods Data of patients with pelvic abscess from October 2011 to August 2016 were retrospectively analyzed to compare three programs： antibiotics, laparoscopy or laparotomy and percutaneous drainage of abscess. Results Altogether 25 patients were enrolled in the study, all suffered from fever and elevated leukocyte count. Among these patients, three were emergency, four had histories of PID, five had pelvic operation recently. Patients treated with antibiotics had longer treatment time to get clinical remission, and sixty percent would relapse. Patients treated with drainage of abscess could have the same effect as those with laparoscopy, except for a lower rate of recovery （relieve rate was 50% and relapse rate 37.5%）. Conclusion Drainage was an effective method to treat pelvic abscess, especially for the patients with complicated disease and high risk of operation.

关 键 词：化脓性盆腔炎 盆腔脓肿 穿刺引流 盆腔炎 

分 类 号：R711.33[医药卫生—妇产科学]