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目的探讨妊娠合并急性阑尾炎的临床特点及诊疗方法,提高其诊断和治疗水平。方法回顾性分析76例妊娠合并急性阑尾炎患者的临床资料。结果 76例患者中孕早期16例,孕中期48例,孕晚期12例;发病于24 h确诊74例,占97.4%,误诊2例,占2.6%;保守药物治疗4例,手术治疗72例,其中单纯阑尾炎切除术64例,剖宫产+阑尾炎切除术8例;手术病例为单纯阑尾炎者无流产和早产的发生,化脓性阑尾炎者流产和早产发生率为23.1%(6/24),阑尾穿孔腹膜炎者流产和早产发生率为38.9%(7/18)。结论妊娠期急性阑尾炎具有阑尾点上移、临床症状和体征不典型、局部感染易扩散等临床特点;孕早期阑尾炎易于诊断,但孕中晚期阑尾炎诊断较困难;根据不同孕期、不同病情采取个体化的治疗方案可获得良好的治疗效果。
Objective To investigate the clinical features and diagnosis and treatment of pregnancy complicated with acute appendicitis and to improve its diagnosis and treatment. Methods The clinical data of 76 patients with acute appendicitis during pregnancy were analyzed retrospectively. Results Among the 76 patients, 16 were in the early pregnancy, 48 in the second trimester and 12 in the third trimester; 74 were diagnosed at 24 h (97.4%), 2 were misdiagnosed (2.6%), 4 were treated with conservative drugs, and 72 , Of which appendectomy alone in 64 cases, cesarean plus appendectomy in 8 cases; surgical cases of appendicitis were abortion and premature birth, suppurative appendicitis abortion and preterm birth rate was 23.1% (6/24) Peritonitis perforation appendix abortion and premature birth rate was 38.9% (7/18). Conclusions Acute appendicitis in pregnancy has the clinical features of appendiculum upturns, clinical symptoms and signs of atypia, easy spread of local infection and so on. It is easy to diagnose appendicitis in early pregnancy, but it is more difficult to diagnose appendicitis in late pregnancy. According to different stages of pregnancy, The treatment program can get a good therapeutic effect.