摘要
目的 为尽早明确诊断 ,赢得抢救和治疗时机 ,减少误诊。方法 本文通过对我科 1997～ 2 0 0 0年收治的 388例妇科急腹症病人的临床资料进行回顾性分析。结果 388例病人包括 10个病种 ,分 4类 :感染性疾病、腹腔内出血性疾病、肿瘤并发症及被误诊为妇科疾病的 ,其构成比为 5 1.0 %、4 5 .3%、2 .4 %和 1.3% ,感染性疾病居第 1位。手术治疗 195例 ,占 5 0 .2 % ,内出血性疾病占 90 .2 %。结论 出血性输卵管炎、异位妊娠、黄体破裂、急性阑尾炎容易互相误诊。因此 ,在诊断感染性疾病时应注意近期不洁同房史或宫腔手术史 ;内出血性疾病应重点询问月经史并监测hCG。后穹窿穿刺是简便而重要的鉴别诊断手段。护理对策 :详细询问病史和进行全面的全身检查及妇科检查 ;密切观察生命体征变化、腹痛的部位、性质、特点以及腹痛与月经的关系 ;急诊工作程序化 :正确处理抢救、治疗、护理3者间的程序关系 ;积极有效的对症护理是拯救病人生命的关键 ;健康教育是预防工作的一个重要环节 ,为病人提供安全的、经济的。
Objective In order to get the definity diagnosis eraly, gain time and lessen misdiagnosis. Methods The clinical data of 388 gynecologic acute abdomen patients were analysed retrospectively. Results It consisted of four kinds of diseases: inflammatory disease (51.0%), intraceliac hemorrhage (45.3%), tumor complication (2.4%) and misdiagnostic gynoeologic disease (1.3%). 195 patients were treated through operation, and the intraceliac hemorrhage were about 90.2%. Conclusions It suggested that hemorrhage salpingitis, ecctopic pregnancy, rupture of corpus luteum and acute appendicitis can be misdiagonosed. Attention should be paid to the gistory of unclean coitus or uterine cavity operation. The menstrual history and hCG should be inquiredand examined carefully. Culclocentesis was the simple but important means for differential diagonsis. Nursing strategies: Inquiring about the disease history carefully and doing general phyiscal check up, especially the gynecologic eamination. Observing vital sings change, site, quality, character of abdominal pain and the relationship with menstruation. Programming the emergency treatment, deling with the relationship among salvage, treatment and nursing care. Effective expectant nursing was of the importance. Health education was also necessary for prevention.
出处
《现代护理》
2002年第3期197-198,共2页
Modern Nursing
关键词
妇科急腹症
护理
鉴别诊断
临床表现
Gynecology Acute abdomen Clinical identification Nursing
