妊娠期阑尾炎穿孔的药物治疗
Medical management of ruptured appendicitis in pregnancy.
作者信息
Young Brett C, Hamar Benjamin D, Levine Deborah, Roqué Henry
机构信息
From the Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
出版信息
Obstet Gynecol. 2009 Aug;114(2 Pt 2):453-456. doi: 10.1097/AOG.0b013e3181998424.
BACKGROUND
Ruptured appendicitis in pregnancy is an advanced stage of appendicitis that imposes significant maternal and fetal morbidity; the best treatment for the obstetric patient in this situation is unclear.
CASES
In the first case, a nulliparous woman at 32 weeks of gestation presented with ruptured appendicitis. She was treated nonsurgically with intravenous antibiotics and had an uncomplicated vaginal delivery at term. In the second case, a nulliparous woman presented at 27 weeks of gestation with ruptured appendicitis and was treated nonsurgically with intravenous antibiotics. She had a recurrence of appendicitis at 32 weeks of gestation, and again was treated with medical management. She delivered a viable infant by cesarean at 34 weeks of gestation for breech presentation and preterm labor.
CONCLUSION
Similar to in the nonpregnant population, medical management of ruptured appendicitis in pregnancy may be a reasonable treatment option.
背景
妊娠期阑尾炎破裂是阑尾炎的晚期阶段，会导致严重的母婴发病率；目前尚不清楚在这种情况下产科患者的最佳治疗方法。
病例
在第一个病例中，一名妊娠32周的初产妇出现阑尾炎破裂。她接受了静脉抗生素非手术治疗，并足月顺产，过程顺利。在第二个病例中，一名妊娠27周的初产妇出现阑尾炎破裂，接受了静脉抗生素非手术治疗。她在妊娠32周时阑尾炎复发，再次接受保守治疗。由于臀位和早产，她在妊娠34周时通过剖宫产分娩出一个存活的婴儿。
结论
与非妊娠人群相似，妊娠期阑尾炎破裂的保守治疗可能是一种合理的治疗选择。
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