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[妇科急症:病因及严重程度]

[Gynecological emergencies: etiology and degree of gravity].

作者信息

Alouini S, Mesnard L, Coly S, Dolique M, Lemaire B

机构信息

Département de chirurgie gynécologique et obstétrique, CHR Orléans, 1, Porte-Madeleine, 45000 Orléans, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2012 Feb;41(1):48-54. doi: 10.1016/j.jgyn.2011.08.004. Epub 2011 Sep 22.

Abstract

OBJECTIVE

To evaluate the type and the emergency degree of the pathologies met in gynecological emergencies.

METHODS

prospective study including 205 patients presented to the Emergency department of a maternity level 3 between the 2011 January 4 and February 15.

RESULTS

One hundred and ninety-four patients (95%) came from their own initiative. One hundred and eighty-one patients (88%) consulted for abdominal/pelvic or lumbar pain and or metrorragia. The mean age of the patients was of 31 ± 11 years and the average waiting time before being examined was of 84 ± 101 minutes. For 94 patients (46%), the diagnosis was an asymptomatic intra-uterine pregnancy in 41 cases or associated with minor symptoms. 21 patients (8.9%) consulted for menstruation with or without dysmenorrhea, 17 (8,3%) had a miscarriage, 14 (7%) a genital infection, 11 (5%) an ovarian pathology and eight (4%) an ectopic pregnancy or its follow-up. Seven patients had an axillary lymphocele or a breast tumor and four symptomatic myomas. Six patients presented with non-gynecological pathologies. In 23 cases (11%) no organic cause was found. Only 24 patients (12%) were hospitalized and nine (4.5%) operated.

CONCLUSION

Most of the patients consulted for minor obstetrical or gynecological pathologies without relation with the function of Emergency department. Ectopic pregnancy remains a rare event. Better information of the users on the significance of the urgency is desirable. Consultation of a referent physician before emergency services should be privileged.

摘要

目的

评估妇科急症中所遇病症的类型及紧急程度。

方法

前瞻性研究,纳入2011年1月4日至2月15日期间在一家三级产科急诊就诊的205例患者。

结果

194例患者(95%)为主动前来就诊。181例患者(88%)因腹部/盆腔或腰部疼痛和/或子宫出血前来咨询。患者的平均年龄为31±11岁,接受检查前的平均等待时间为84±101分钟。94例患者(46%)的诊断为无症状宫内妊娠,其中41例为单纯无症状宫内妊娠,或伴有轻微症状。21例患者(8.9%)因月经问题前来咨询,有或无痛经,17例(8.3%)发生流产,14例(7%)有生殖器感染,11例(5%)有卵巢病变,8例(4%)为异位妊娠或其随访情况。7例患者有腋窝淋巴管瘤或乳腺肿瘤,4例有症状性肌瘤。6例患者患有非妇科病症。23例(11%)未发现器质性病因。仅24例患者(12%)住院,9例(4.5%)接受手术。

结论

大多数患者因轻微产科或妇科病症前来咨询,与急诊科功能无关。异位妊娠仍然是罕见事件。需要更好地向患者告知紧急情况的重要性。在急诊服务前应优先咨询专科医生。

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