抗生素联合中药及超声引导介入治疗输卵管积脓32例的临床效果分析  

Clinical effect analysis of 32 cases of pyosalpinx treated by antibiotics combined with Traditional Chinese Medicine and ultrasound-guided intervention

作　　者：陈思[1,2] 王静[1,2] 王佩娟[1,2] CHEN Si;WANG Jing;WANG Peijuan(Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing,Jiangsu,210028,China;Jiangsu Province Hospital of Integrated Traditional Chinese andWestern Medicine,Nanjing,Jiangsu,210028,China)

机构地区：[1]南京中医药大学附属中西医结合医院,江苏南京210028 [2]江苏省中西医结合医院,江苏南京210028

出　　处：《当代医学》2022年第8期1-4,共4页Contemporary Medicine

基　　金：国家自然科学基金青年项目(81904245);江苏省临床前沿技术重大发展项目(BE2019766)。

摘　　要：目的探讨输卵管积脓的病因、鉴别诊断及有效治疗手段。方法选取2017年4月至2019年2月江苏省中西医结合医院收治的32例输卵管积脓患者,对其一般资料、临床症状、检查结果、鉴别诊断和治疗等方面进行回顾性分析。结果输卵管积脓的高危因素包括不洁性生活史、阴道炎症、宫内置环、盆腔手术史或合并阑尾炎、糖尿病等;临床症状主要表现为反复性下腹部疼痛,伴发热、胃肠症状等;血常规提示高敏C反应蛋白升高,妇科B超提示盆腔包块,漏诊率为12.5%(4/32);抗生素联合中药及超声引导介入治疗输卵管积脓可缓解临床症状,平均住院12.10 d,复发率为3.13%(1/32)。结论输卵管积脓病因多样,临床表现复杂,常误诊漏诊,且治疗不彻底易迁延不愈,继发多种疾病。输卵管积脓的治疗应尽早行超声引导脓腔冲洗以清除局部感染病灶,根据药物敏感试验结果选择敏感抗生素并联合中医辨证论治予以全身治疗。中西医结合治疗效果显著,复发率低,值得临床推广。Objective To study the etiology,differential diagnosis and the perfectly effective therapy of pyosalpinx.Methods 32 patients with pyosalpinx treated in Jiangsu Province Hospital of Integration Traditional Chinese and Western Medicine were collected,the general information,clinical characteristics,laboratory tests,differential diagnosis and treatment of all patients were retrospectively analyzed.Results The high risk factors of pyosalpinx included sexual history of impurity,vaginal inflammation,intrauterine ring,history of pelvic surgery,complicated with appendicitis,diabetes,and so on.The clinical symptoms contained recurrent abdominal pain,fever and gastrointestinal symptoms.Blood routine examination indicated elevated blood image,ultrasound pointed outpelvic masses,the missed diagnosis rate was 12.5%(4/32);antibiotics combined with Traditional Chinese Medicine and ultrasound-guided interventional treatment of tubal abscess could alleviate clinical symptoms,with the average days of hospitalization was 12.10 days and the recurrence rate was 3.13%(1/32).Conclusion The clinical manifestations of tubal empyema are complexand changeable.It is not uncommon for it to escape diagnosis or be misdiagnosed.If the treatment is not thorough,it is easy to delay and secondary to a variety of diseases.For the treatment of tubal empyema,ultrasound-guided purulent cavity drainaging and rinsing is as early as possible to clear the local infection.Sensitive antibiotics should be selected on the basis of bacterial culture,combined with Traditional Chinese Medicine for syndrome differentiation and systemic treatment.The curative effect of integrated Traditional Chinese and Western Medicine is definiteand,the recurrence rate is low,it is worthy of clinical application.

关 键 词：输卵管积脓 中医药 超声引导介入 抗生素 

分 类 号：R711.76[医药卫生—妇产科学]