探讨妊娠合并急性阑尾炎临床特征、诊断及治疗。

对2008年1月至2015年12月就诊于广州医科大学附属第三医院妇产科的81例妊娠合并急性阑尾炎住院患者的临床资料进行回顾性分析。

(1)临床症状和体征：81例妊娠合并急性阑尾炎，93.83%的患者以腹痛来就诊，具有典型的转移性右下腹痛占28.39%；患者入院平均体温为(37.17±0.70)℃。(2)辅助检查：白细胞(13.82±4.84)×10⁹个/L，中性粒细胞数为(11.72±4.88)×10⁹个/L，中性粒细胞百分比为82.89%，C-反应蛋白为(92.49±61.31)mg/L，降钙素原为(0.20±0.28)ng/ml。(3)治疗：手术治疗者35例，使用抗生素非手术治疗者46例。孕中期行腹式阑尾切除术17例，孕晚期行剖宫产加阑尾切除术18例，术后病理报告类型以急性化脓性阑尾炎(15例)为主。

掌握妊娠合并急性阑尾炎的临床特点，做到早期诊断和正确处理对妊娠结局有重要影响。

To investigate the clinical features, diagnosis and treatment in pregnant women with acute appendicitis.

From January 2008 to December 2015, the clinical data of 81 pregnant women with acute appendicitis who were admitted to the department of obstetrics and gynecology in the Third Affiliated Hospital of Guangzhou Medical University were analyzed retrospectively.

(1) Clinical symptoms: Abdominal pain was the predominant symptom, with an occurrence rate of 92.59 percent in 81 patients; and 28.39 percent of patients had migration of pain to right lower quadrant. In all cases, the average of body temperature was (37.17±0.70)℃. (2) Tests: In all cases, the white blood cell (WBC) count was (13.82±4.84)×10⁹ per L, neutrophil count was (11.72±4.88)×10⁹ per L, neutrophil percentage was 82.8 percent, C-reactive protein was (92.49±61.31) mg/L, and procalcitonin was (0.20±0.28) ng/ml. (3) Treatment: Thirty-five patients required appendectomy, while 46 patients were treated by parenteral antibiotic treatment, without nonoperative management. Among the 35 patients, 17 cases received open appendectomy in the second trimester, and the other 18 cases had appendectomy during caesarean section in the third trimester. Fifteen cases were diagnosed as acute suppurative appendicitis by pathological examination after operation.

Master the clinical characteristics of pregnant patients with acute appendicitis and performed early diagnosis and proper treatment, which were important for the pregnancy outcome.