摘要:
目的 探讨女性宫腔积脓的病因、临床特点、诊断及治疗方法.方法 回顾性分析昆明医科大学第一附属医院妇科2003年1月至2015年12月收治的31例宫腔积脓患者的临床资料.结果 宫颈引流不畅为本病的根本原因.患者临床表现不典型,31例患者中,4例患者无任何症状(12.90%),腹痛22例(70.97%),阴道排液27例(87.09%),脓血性恶臭分泌物物12例(38.71%),发热3例(9.70%).妇科超声检查为重要的诊断手段,扩张宫颈引流出脓液可确诊.扩张宫颈引流,宫腔置弗雷氏导尿管,以0.9%Na Cl溶液、甲硝唑、庆大霉素冲洗宫腔,并辅以抗生素静脉滴注为有效的治疗方法.结论 宫腔积脓的症状不典型,妇科超声检查极具临床意义,充分宫颈扩张并引流是保守治疗成功的关键,可取得良好的效果.如合并子宫内膜癌等恶性肿瘤应根据患者耐受能力尽早采取手术治疗.
Abstract:
Objective To investigate the etiology, clinical characteristics, diagnosis and treatment of female uterine empyema.Methods We retrospectively analyzed the clinical data of 31 patients with uterine empyema in our hospital from January 2003 to December 2015.Results Uterine empyema was caused as a result of occlusion of the cervical canal,Patients had no typical symptoms,four cases had no symptoms(12.90%),twenty-two cases had abdominal pain(70.97%),twenty-seven cases had vaginal discharge(98.09%) and twelve cases had sanguinopurulent material(38.71%),three cases of them had fever(9.70%).Gynecological ultrasound examination was an important diagnostic tool.Dilatation of cervix, discharging purulent material, antibiotics treatment,the cervical adhesions were manually broken down to establish a patent cervical lumen to accommodate a uterine Fleischl catheter,the uterus was lavaged with 0.9% Nacl solution, metronidazole,gentamicin.The above treatment got a good therapeutic effect.Conclusion Pyometra has atypical symptoms with difficult diagnosis,and develops gradually.Gynecological ultrasound examination has great clinical significance.Full dilatation of cervix,discharging purulent material are the key to the success of conservation treatment and can achieve good results.Combination of endometrial cancer or other malignant tumor patients should take surgery as soon as possible,according to the tolerance ability.
点击查看大图
下载:
