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[妊娠期急性阑尾炎]

[Acute appendicitis in pregnancy].

作者信息

Barros F de C, Kunzle J R, Ribeiro Filho J do A

机构信息

Serviço de Cirurgia de Ribeirão Preto, SP.

出版信息

Rev Paul Med. 1991 Jan-Feb;109(1):9-13.

PMID:1882175
Abstract

A retrospective analysis of acute appendicitis during pregnancy in patients seen at the Surgical Service of Ribeirão Preto between December 1959 and December 1988 showed that out of 18,065 deliveries performed there were 7 cases of acute appendicitis (0.038%). Gestational age in which acute appendicitis developed varied from the 11th to the 27th week, the second trimester prevailing. Both in pregnant and in non-pregnant patients, clinical history of appendicitis was similar, except for a few cases in which the cecum, mobile as it is, caused localized pain in a more cranial position. Acute appendicitis during pregnancy showed a more aggressive evolution and despite a period lower than 24 hours, only two of our patients did not exhibit a purulent secretion in the abdomen during surgery. The two patients with a prolonged time of history had necrosed and perforated appendices. There was no maternal mortality. Among complications observed, wall abscess (14%), adynamic ileum (14%), and premature labor (28%) were the most important. Inhibition was not possible in one of the cases of premature labor, with the birth of a live fetus on the second postoperative day. The fetus died eventually. Other patients gave birth to live and timely fetuses.

摘要

对1959年12月至1988年12月在里贝朗普雷图外科就诊的妊娠期急性阑尾炎患者进行的回顾性分析显示,在该科室进行的18065例分娩中,有7例急性阑尾炎(0.038%)。急性阑尾炎发生时的孕周从第11周变化至第27周,其中孕中期最为常见。无论是孕妇还是非孕妇,阑尾炎的临床病史相似,只是少数病例中,活动的盲肠导致疼痛部位更靠近头侧。妊娠期急性阑尾炎病情发展更为迅猛,尽管发病时间短于24小时,但手术时仅2例患者腹腔内没有脓性分泌物。病史较长的2例患者阑尾已坏死穿孔。无孕产妇死亡。观察到的并发症中,腹壁脓肿(14%)、麻痹性肠梗阻(14%)和早产(28%)最为常见。其中1例早产无法抑制,术后第二天产下活胎,最终胎儿死亡。其他患者均产下存活且适时的胎儿。

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