盆腔脓肿致脓毒性休克诊治分析  

Diagnosis and treatment of septic shock caused by pelvic abscess

作　　者：王锐晨 田昭 祝洪澜[1] 张果[1] 邓浩[1] 梁旭东[1] 王建六[1] WANG Ruichen;TIAN Zhao;ZHU Honglan;ZHANG Guo;DENG Hao;LIANG Xudong;WANG Jianliu(Department of Obstetrics and Gynecology,Peking University People’s Hospital,Bejing 100044,China)

机构地区：[1]北京大学人民医院妇科,100044

出　　处：《中国妇产科临床杂志》2022年第5期492-494,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：豪森临床医学学科发展项目(2020-J-05)。

摘　　要：目的研究盆腔脓肿临床诊治要点及其所致脓毒性休克的识别和治疗方式。方法回顾性分析2012年4月至2022年4月北京大学人民医院妇科收治盆腔脓肿患者共计81例,本文对其资料进行分析,特别是感染相关指标、病原学及影像学、手术方式进行分析。结果盆腔脓肿症状以腹痛(79.0%,64/81),发热(50.6%,41/81),消化系统表现(28.4%,23/81)为主,化验指标白细胞计数[(12.02±5.54)×10^(9)/L],C反应蛋白(111.20±76.61)mg/L,明显升高。脓液及组织培养病原体77例,培养出大肠埃希菌42例(54.5%)。开腹手术28例,腹腔镜手术37例,超声引导下脓肿穿刺引流术7例,手术治疗有效率97.2%(70/72)。盆腔脓肿致脓毒性休克患者8例,治疗有效率75.0%(6/8)。结论早期识别盆腔脓肿的临床表现、完善相关检查至关重要,合并脓毒性休克者需多学科联合诊治。Objective To study the clinical diagnosis and treatment of pelvic abscess and septic shock caused by it.Methods 81 patients with pelvic abscess treated in the Department of Gynecology of Peking University People’s Hospital from April 2012 to April 2022 were retrospectively analyzed.The data,especially the relevant infection indicators,etiology,imaging and surgical methods were analyzed.Results The main symptoms of pelvic abscess were abdominal pain(79.0%,64/81),fever(50.6%,41/81)and digestive system symptoms(28.4%,23/81).The laboratory indicators were white blood cell count[(12.02±5.54)×10^(9)/l],C-reactive protein(111.20±76.61)mg/l,which were significantly increased.The pus and tissues of 77 patients were sent to culture pathogen,and 42 cases(54.5%)of them were cultured with Escherichia coli.28patients underwent laparotomy,37 patients underwent laparoscopic surgery,and 7 patients underwent abscess puncture and drainage guided by ultrasound.The effective rate of surgical treatment was 97.2%(70/72).There were 8 cases of septic shock caused by pelvic abscess,and the effective rate of treatment was 75.0%(6/8).Conclusions Early recognition of the clinical manifestations of pelvic abscess and improvement of relevant examinations are very important.For patients with septic shock caused by pelvic abscess,multidisciplinary joint diagnosis and treatment is necessary.

关 键 词：盆腔脓肿 盆腔感染性疾病 脓毒性休克 

分 类 号：R711.33[医药卫生—妇产科学] R459.7[医药卫生—临床医学]