Acute Appendicitis during Pregnancy

妊娠中合併闌尾炎

陳俊芳(Chun-Fang Chen) ； 嚴守智(Sou-Jhy Yen) ； 譚光還(Kuang-Huan Tan) ； 石奉周(Feng-Chu Shin) ； 陳宏一(Hong-I Chen)

《Journal of Medical Sciences》 19卷4期 (1999/02) Pp. 256-262

摘要

從民國80年一月至86年7月5年之間，有16名懷孕婦女被診斷為闌尾炎而接受開腹手術。其中14名經過病理組織學證實的患者都接受此一回顧性研究。依據結果顯示，闌尾炎之發生在第二懷孕期最多，以29歲到35歲的經產婦最常見。臨床症狀以腹痛、噁心、食慾差出現頻率最高，至於理學檢查則常見腹部壓痛及反彈痛。本研究中，闌尾炎破裂的患者其白血球總數大於18000，其中顆粒性白血球大於90%且症狀出現超過24小時才住院。手術後有29%發生早期收縮，產婦及胎兒均未見有其他嚴重的併發症。我們建議一旦孕婦懷疑有闌尾炎應儘早接受手術積極治療，術後應配合密切的子宮胎兒監測，減少胎兒或產婦併發症的發生。

關鍵字

闌尾炎 ； 妊娠

並列摘要

Fourteen patients underwent appendectomy during pregnacy. The clinical presentation of acute appendicitis is altered during gestation, and diagnosis becomes increasingly difficult when close to term. Abdominal pain, nausea, anorexia and vomiting are important symptoms. Peritoneal signs occurred at the right lower quadrant and entire right side are more common locations. Leukocytosis with WBC count＞18000/cumm and prolonged symptomatic duration (＞ 24 hours) were indications that appendiceal perforation might have occurred. In the group of one patient with perforation, there was no maternal death or fetal loss. Prompt diagnosis is the cornerstone of a good outcome, and early surgical intervention is indicated if acute appendicitis is suspected. Pregnancy is not a reason to delay surgery. Close fetal monitoring after the operation is mandatory and reduces the occurrence of fetal or maternal loss.

並列關鍵字

acute appendicitis ； pregnancy