摘要
目的:分析由外院转至我院的产后严重盆腔感染患者的临床特点及诊治。方法:回顾性分析2010年1月至2017年10月陆军军医大学第一附属医院产科收治的9例产后重症盆腔感染转院患者的临床资料。结果:(1)9例患者中6例孕妇在二级医院分娩,3例孕妇在当地乡镇卫生院分娩。3例经阴道分娩,剖宫产6例。6例剖宫产中2例为择期剖宫产(1例为瘢痕子宫,1例为社会因素),中转剖宫产4例。(2)9例患者产后均出现高热,体温38.9℃~41℃;7例患者伴下腹痛,2例无明显腹痛;4例患者出现剖宫产术后肠梗阻症状。1例患者剖宫产术后第11天因感染性胸主动脉瘤破裂死亡。(3)8例患者经静脉抗感染治疗、引流或清除感染灶后治愈出院。结论:不建议无指征的中孕引产及剖宫产手术。重视可疑感染性剖宫产患者术中术后治疗性引流的作用。产后体温升高、下腹痛及肠梗阻症状可能是严重盆腔感染的早期症状,抗生素保守治疗无效时应积极手术治疗。
Objective:To investigate the clinical features,diagnosis,and treatment of patients with severe pelvic infection referred to our hospital from other hospitals.Methods:A retrospective analysis was performed for the clinical data of 9 patients with severe pelvic infection during the postpartum period who were admitted to the First Affiliated Hospital of Army Medical University from January 2010 to October 2017.Results:Of all patients,6 gave birth in a secondary hospital and 3 gave birth in a local health center;3 adopted vaginal delivery,and 6 underwent cesarean section.Among the 6 patients who underwent cesarean section,2 underwent elective cesarean section(among whom 1 had scarred uterus and 1 underwent cesarean section due to social factors)and 4 were converted to cesarean section due to failed vaginal delivery.All 9 patients had severe fever after delivery,with a body temperature of 38.9℃-41℃;of all patients,7 had lower abdominal pain and 2 had no obvious abdominal pain;4 patients had intestinal obstruction after cesarean section.One patient died of the rupture of infectious thoracic aortic aneurysm on day 11 after cesarean section,and the other 8 patients were cured and discharged after intravenous anti-infective therapy,drainage,or removal of the foci of infection.Conclusions:Induction of labor in midtrimester pregnancy and cesarean section without indications are not recommended.The role of drainage during and after surgery should be taken seriously in patients who undergo cesarean section and are suspected of infection.Increased body temperature after delivery,lower abdominal pain,and intestinal obstruction symptoms may be early symptoms of severe pelvic infection,and surgical treatment should be given if conservative treatment with antibiotics achieves no response.
作者
余美佳
刘鹤莺
严小丽
王丹
常青
Yu Meijia;Liu Heying;Yan Xiaoli;Wang Dan;Chang Qing(Department of Gynecology and Obstetrics,the First Affiliated Hospital,Army Medical University)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2019年第8期1103-1105,共3页
Journal of Chongqing Medical University
关键词
产褥期
盆腔感染
转诊
剖宫产
puerperium
pelvic infection
referral
cesarean section
