Department of Obstetrics and Gynaecology, Akershus University Hospital, 1478 Lørenskog, Norway.
Best Pract Res Clin Obstet Gynaecol. 2009 Oct;23(5):667-78. doi: 10.1016/j.bpobgyn.2009.01.010. Epub 2009 Feb 20.
The optimum treatment for pelvic abscess would be an approach that is safe, efficacious, cost-effective, minimally invasive, and which affects the woman's fertility potential as little as possible. In women of reproductive age tubo-ovarian abscess is one of the most common types of pelvic abscess. Tubo-ovarian abscesses are classically treated with broad-spectrum antibiotics. Frequently this approach fails and surgical intervention becomes necessary in about 25% of all cases. Surgical procedures include laparotomy or laparoscopy with drainage of abscess, unilateral or bilateral salpingo-ophorectomy, and hysterectomy. However, surgery for tubo-ovarian abscess is often technically difficult and associated with complications. An alternative approach is the use of imaging-guided drainage of abscess in combination with antibiotics. Combined data from several studies indicate that ultrasound-guided transvaginal drainage with concomitant antibiotics is especially safe and efficacious. This chapter discusses the management of pelvic abscess with a special focus on transvaginal ultrasound-guided drainage of tubo-ovarian abscess.
对于盆腔脓肿，最佳的治疗方法应该是安全、有效、具有成本效益、微创，并且对女性的生育潜力影响尽可能小。在育龄妇女中，输卵管卵巢脓肿是最常见的盆腔脓肿类型之一。输卵管卵巢脓肿的经典治疗方法是使用广谱抗生素。但这种方法通常会失败，约 25%的病例需要手术干预。手术包括剖腹手术或腹腔镜手术，以引流脓肿、单侧或双侧输卵管卵巢切除术和子宫切除术。然而，输卵管卵巢脓肿的手术通常具有技术难度，并且会伴有并发症。另一种方法是使用影像学引导的脓肿引流联合抗生素治疗。来自几项研究的综合数据表明，超声引导下经阴道引流联合抗生素治疗特别安全有效。本章讨论了盆腔脓肿的治疗方法，特别关注了经阴道超声引导下的输卵管卵巢脓肿引流。
