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妊娠中期急性化脓性阑尾炎伴穿孔患者的护理:一例报告

Nursing care of patients with acute suppurative appendicitis and perforation in mid pregnancy: A case report.

作者信息

Sun Bin, Zhang Na, He Xiuying

机构信息

Department of the International Special Needs Ward, First Hospital of China Medical University, Shenyang, Liaoning Province, China.

Department of Hepatobiliary Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, China.

出版信息

Medicine (Baltimore). 2025 Jul 25;104(30):e43556. doi: 10.1097/MD.0000000000043556.

Abstract

RATIONALE

Pregnancy complicated with appendicitis is a common and serious disease, with atypical clinical manifestations and easy confusion of diseases. The prognosis is mainly related to early diagnosis and timely surgical treatment, as well as the gestational age.

PATIENT CONCERNS

This is a patient in mid pregnancy who experienced abdominal pain, high fever for several days, and examination reports indicating acute appendicitis. Due to congestion of pelvic organs and appendix during pregnancy, inflammation developed rapidly, resulting in suppuration and perforation of the appendix, requiring emergency surgery.

DIAGNOSES

The final diagnosis is mid pregnancy, acute suppurative appendiceal perforation.

INTERVENTIONS

Due to the need to alleviate the patient's current symptoms and protect the fetus during pregnancy, emergency surgery is required. During the surgery, the patient's appendix was found to have suppurative perforation and severe infection. After the surgery, a large amount or combination of antibiotics is needed, but the impact of the drugs on the fetus should be considered. Therefore, anti-infection, nutritional support, and fetal protection treatment should be carried out simultaneously.

OUTCOMES

The patient's infection decreased, fever symptoms disappeared and there was no abdominal pain after eating. The fetus was not affected by the disease and was discharged smoothly.

LESSONS

For pregnant patients, both the patient, and the fetus should be treated and protected simultaneously. By studying this case, we aim to enhance the clinical thinking of nursing staff and improve the quality of nursing service technology.

摘要

理论依据

妊娠合并阑尾炎是一种常见且严重的疾病,临床表现不典型,疾病易混淆。预后主要与早期诊断、及时手术治疗以及孕周有关。

患者关注

这是一名妊娠中期的患者,经历了腹痛、高热数天,检查报告显示为急性阑尾炎。由于孕期盆腔器官和阑尾充血,炎症迅速发展,导致阑尾化脓穿孔,需要急诊手术。

诊断

最终诊断为妊娠中期,急性化脓性阑尾穿孔。

干预措施

由于需要缓解患者当前症状并在孕期保护胎儿,需要进行急诊手术。手术中发现患者阑尾化脓穿孔且感染严重。术后需要大量使用或联合使用抗生素,但应考虑药物对胎儿的影响。因此,应同时进行抗感染、营养支持和胎儿保护治疗。

结果

患者感染减轻,发热症状消失,进食后无腹痛。胎儿未受疾病影响,顺利出院。

经验教训

对于妊娠患者,应同时治疗和保护患者及胎儿。通过研究此病例,我们旨在增强护理人员的临床思维,提高护理服务技术质量。

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本文引用的文献

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Management of Complicated Appendicitis During Pregnancy in the US.美国妊娠期复杂性阑尾炎的管理
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A Review of Antibiotic Use in Pregnancy.孕期抗生素使用综述。
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Magnesium in Prevention and Therapy.镁在预防与治疗中的应用。
Nutrients. 2015 Sep 23;7(9):8199-226. doi: 10.3390/nu7095388.

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