盆腔脓肿的临床特点和诊治分析

李永梅，刘满梅，熊英

宁夏医科大学总医院妇科，宁夏 银川，750003

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摘要：

目的 分析盆腔脓肿的临床特点，探讨诊断及治疗方法。方法 收集 2016年 2月 1日至 2017年 1月 31日在宁夏医科大学总医院及心脑血管病医院妇科收治的盆腔脓肿患者 50例，对其一般资料、临床表现、实验室检查、超声检查、术前诊断及治疗等方面进行分析。结果 盆腔脓肿患者具有复杂多样的临床表现，其中主要有下腹反复性疼痛、发热、盆腔包块等。随着疾病的治疗进展，血清 CA125水平发生显著变化。患者的红细胞沉降率增高，可协助诊断，脓液普通细菌培养阳性率低。超声影像图表现复杂多样，缺乏特异性的表现。药物保守治疗复发率高。结论 将超声与病史、相关实验室检测（血清 CA125、血象等）相结合开展研究，可提高盆腔脓肿的诊断准确性。盆腔脓肿的治疗应在抗感染的基础上，尽早行腹腔镜探查，清除感染病灶，减轻患者痛苦，减少并发症。

关键词：盆腔脓肿；输卵管卵巢脓肿；超声检查；血清 CA125；血象；脓液培养

中图分类号：R711.3文献标志码：A文章编号：2096-1413(2018)07-0072-03

Clinical characteristics, diagnosis and treatment of pelvicabscess


LIYong-mei,LIU Man-mei,XIONG Ying
(Gynecology Department, General Hospital of Ningxia Medical University, Yinchuan 750003,China)



ABSTRACT: Objective To analyze the clinical characteristics of pelvic abscess and explore the methods of diagnosis and treatment. Methods A total of 50 cases of pelvic abscess patient streated in gynecological department of General Hospital of Ningxia Medical University and Cerebrovascular Disease Hospital from February 1,2016 to January 31,2017 were selected, whose general condition, clinical manifestation, laboratory examination, ultrasonic examination, preoperative diagnosis and treatment were analyzed. Results Pelvic abscess patients were complicated with complex and diverse clinical manifestations, including recurrent abdominal pain, fever, pelvic massand so on. With the progress of disease treatment, the level of serum CA125 significantly changed. The erythrocy tesedimentation rate increased in patients, which can help to diagnose,and the positive rate of pusordinary bacterial culture was low.The sonographic images results were diverse and complex, which was lack of specificity. The recurrence rate of conservative treatment was high. Conclusion Combining ultra sound with medical history, related laboratory tests (serum CA125,blood picture,etc.) can promote the diagnostic accuracy of pelvic abscess. For patients with pelvic abscess, laparoscopic removal of infected lesions should be implemented as early as possible,so as to reduce patients ’ pain and complications.  　                    

KEYWORDS: pelvicabscess; tubo-ovarian abscess; ultrasound examination; serum CA125; hemogram; pusculture

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