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[妊娠期阑尾炎]

[Appendicitis in pregnancy].

作者信息

Retzke U, Graf H, Schmidt M

机构信息

Klinik für Frauenheilkunde und Geburtsmedizin, Klinikum Suhl/Thüringen.

出版信息

Zentralbl Chir. 1998;123 Suppl 4:61-5.

PMID:9880877
Abstract

The incidence of appendicitis is about 1:1000-1:1500 pregnancies. Therefore, it seems to be in pregnancy as frequent as in the general population. The common signs and symptoms of appendicitis are in pregnancy less reliable than in nonpregnant women. An important role to diagnose appendicitis in suspicious cases has the ultrasonography, first of all the "graded compression ultrasound". Appendicitis increases the rate of spontaneous abortions, preterm delivery, small for gestation babies, and neonatal mortality in the first 7 days of life. After appendectomy the rate for preterm deliveries is increased for seven days. After the 7th postoperative day the pregnancy usually continuous to term. There is no increase of malformations because of appendectomy. At the end of pregnancy appendicitis is frequently complicated by phlegmoneous and perforated forms of illness with and without peritonitis. Before 20th w.o.p. laparoscopy is a recommendable method to diagnose and treat appendicitis. After 20th week of pregnancy laparotomy should be preferred. Cesarean section is not recognized part of treatment for appendectomy and only to be performed for obstetric reasons. Tocolysis should be prevented because of risk of pulmonary injury.

摘要

阑尾炎在妊娠中的发病率约为1:1000 - 1:1500。因此,其在妊娠中的发生率似乎与普通人群一样频繁。阑尾炎的常见体征和症状在妊娠时比非妊娠女性更不可靠。在可疑病例中,超声检查,尤其是“分级压迫超声”,在诊断阑尾炎方面起着重要作用。阑尾炎会增加自然流产、早产、小于孕周儿以及出生后7天内新生儿死亡率的发生率。阑尾切除术后,早产率会在7天内升高。术后第7天之后,妊娠通常会持续至足月。阑尾切除术不会增加畸形发生率。妊娠末期,阑尾炎常并发蜂窝织炎和穿孔性疾病,伴或不伴有腹膜炎。妊娠20周前,腹腔镜检查是诊断和治疗阑尾炎的推荐方法。妊娠20周后,应首选剖腹手术。剖宫产不被视为阑尾切除术治疗的一部分,仅在产科原因时进行。由于存在肺损伤风险,应避免使用宫缩抑制剂。

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