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中华产科急救电子杂志 ›› 2024, Vol. 13 ›› Issue (03) : 135 -140. doi: 10.3877/cma.j.issn.2095-3259.2024.03.002

妊娠期非产科手术

妊娠期急性阑尾炎
肖露, 黄莉萍()   
  1. 510515 广州,南方医科大学南方医院妇产科
  • 收稿日期:2024-06-15 出版日期:2024-08-18
  • 通信作者: 黄莉萍

Acute appendicitis during pregnancy

Lu Xiao, Liping Huang()   

  • Received:2024-06-15 Published:2024-08-18
  • Corresponding author: Liping Huang
引用本文:

肖露, 黄莉萍. 妊娠期急性阑尾炎[J/OL]. 中华产科急救电子杂志, 2024, 13(03): 135-140.

Lu Xiao, Liping Huang. Acute appendicitis during pregnancy[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2024, 13(03): 135-140.

妊娠期急性阑尾炎是妊娠期最常见的非产科急腹症之一。由于受到妊娠期生理变化的影响,诊断较为困难,而延误诊治将导致不良母胎结局风险增加。妊娠期急性阑尾炎推荐多学科共同管理,多建议手术治疗。手术方式包括开腹与腹腔镜,根据不同孕周子宫大小进行选择。本文从生理特点、临床诊断、治疗进展等方面对妊娠期急性阑尾炎进行论述,期望为妊娠期急性阑尾炎的及时识别和诊治提供更多依据,以减少母胎不良结局的发生。

Acute appendicitis is one of the most common non-obstetric acute abdominal conditions during pregnancy. Physiological and anatomical changes associated with pregnancy can make the diagnosis particularly challenging. Delayed diagnosis and treatment can lead to increased adverse outcomes for both the mother and fetus. It is recommended that a multidisciplinary team approach be taken for diagnosis and treatment. Surgical intervention is often recommended for appendicitis. Surgical options include laparotomy and laparoscopy, with the choice depending on the size of the uterus at different gestational weeks. This article reviews the physiological characteristics and latest progress in the diagnosis and treatment of appendicitis during pregnancy, aiming to improve the recognition and treatment of acute appendicitis and avoid adverse outcomes for both the mother and fetus.

表1 RIPASA评分
表2 Tzanakis评分
[1]
Kumar SS, Collings AT, Wunker C, et al. SAGES guidelines for the use of laparoscopy during pregnancy[J]. Surg Endosc202438(6):2947-2963.
[2]
Theilen LH, Mellnick VM, Shanks AL, et al. Acute appendicitis in pregnancy: predictive clinical factors and pregnancy outcomes[J]. Am J Perinatol201734(6):523-528.
[3]
Abbasi N, Patenaude V, Abenhaim HA. Management and outcomes of acute appendicitis in pregnancy-population-based study of over 7000 cases[J]. BJOG2014121(12):1509-1514.
[4]
Mourad J, Elliott JP, Erickson L, et al. Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs[J]. Am J Obstet Gynecol2000182(5):1027-1029.
[5]
谢幸,孔北华,段涛. 妇产科学[M]. 9版.北京:人民卫生出版社,2018:129.
[6]
Hu JX, Zhao CF, Wang SL, et al. Acute pancreatitis: a review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence[J]. World J Gastroenterol202329(37):5268-5291.
[7]
Bridwell RE, Carius BM, Long B, et al. Sepsis in Pregnancy: Recognition and Resuscitation[J]. West J Emerg Med201920(5):822-832.
[8]
Bardakçi O, Bahçecioǧlu ⅰB, Tatli F, et al. Does one of the two most commonly used scoring systems have a decisive advantage over the other in diagnosing acute appendicitis in pregnant women?[J]. Medicine (Baltimore)2023102(17):e33596.
[9]
Mantoglu B, Gonullu E, Akdeniz Y, et al. Which appendicitis scoring system is most suitable for pregnant patients? A comparison of nine different systems[J]. World J Emerg Surg202015(1):34.
[10]
Skjold-Ødegaard B, Søreide K. The diagnostic differentiation challenge in acute appendicitis: how to distinguish between uncomplicated and complicated appendicitis in adults[J]. Diagnostics (Basel)202212(7):1724.
[11]
Frountzas M, Stergios k, Kopsini d, et al. Alvarado or RIPASA score for diagnosis of acute appendicitis? A meta-analysis of randomized trials[J]. Int J Surg201856:307-314.
[12]
Augustin G, Mikus M, Bogdanic B, et al. A novel Appendicitis TriMOdal prediction Score (ATMOS) for acute appendicitis in pregnancy: a retrospective observational study[J]. Updates Surg202274(6):1933-1941.
[13]
Kenington JC, Pellino G, Iqbal MR, et al. Guidelines on general surgical emergencies in pregnancy[J]. Br J Surg2024111(3):znae051
[14]
Moghadam MN, Salarzaei M, Shahraki Z. Diagnostic accuracy of ultrasound in diagnosing acute appendicitis in pregnancy: a systematic review and meta-analysis[J]. Emerg Radiol202229(3):437-448.
[15]
Abgottspon D, Putora K, Kinkel J, et al. Accuracy of point-of-care ultrasound in diagnosing acute appendicitis during pregnancy[J]. West J Emerg Med202223(6):913-918.
[16]
Burke LM, Bashir MR, Miller FH, et al. Magnetic resonance imaging of acute appendicitis in pregnancy: a 5-year multiinstitutional study[J]. Am J Obstet Gynecol2015213(5):693.e1-693.e6.
[17]
Motavaselian M, Bayati F, Amani-Beni R, et al. Diagnostic performance of magnetic resonance imaging for detection of acute appendicitis in pregnant women; a systematic review and meta-analysis[J]. Arch Acad Emerg Med202210(1):e81.
[18]
Kave M, Parooie F, Salarzaei M. Pregnancy and appendicitis: a systematic review and meta-analysis on the clinical use of MRI in diagnosis of appendicitis in pregnant women[J]. World J Emerg Surg201914:37.
[19]
D′Souza N, Hicks G, Beable R, et al. Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis[J]. Cochrane Database Syst Rev202112(12):CD012028.
[20]
Dahabreh IJ, Adam GP, Halladay CW, et al. Diagnosis of right lower quadrant pain and suspected acute appendicitis[EB/OL].(2015-12-14)[2024-06-15].

URL    
[21]
Kenington JC, Pellino G, Iqbal MR, et al. Guidelines on general surgical emergencies in pregnancy[J]. Br J Surg2024111(3):znae051.
[22]
Ashbrook M, Cheng V, Sandhu K, et al. Management of complicated appendicitis during pregnancy in the US[J]. JAMA Netw Open20225(4):e227555.
[23]
Pearl JP, Price RR, Tonkin AE, et al. SAGES guidelines for the use of laparoscopy during pregnancy[J]. Surg Endosc201731(10):3767-3782.
[24]
Liu YX, Zhang Y, Huang JF, et al. Meta-analysis comparing the safety of laparoscopic and open surgical approaches for suspected adnexal mass during the second trimester[J]. Int J Gynaecol Obstet2017136(3):272-279.
[25]
Sedaghat N, Cao AM, Eslick GD, et al. Laparoscopic versus open cholecystectomy in pregnancy: a systematic review and meta-analysis[J]. Surg Endosc201731(2):673-679.
[26]
Chakraborty J, Kong JC, Su WK, et al. Safety of laparoscopic appendicectomy during pregnancy: a systematic review and meta-analysis[J]. ANZ J Surg201989(11):1373-1378.
[27]
Ball E, Waters N, Cooper N, et al. Evidence-based guideline on laparoscopy in pregnancy: commissioned by the British Society for Gynaecological Endoscopy (BSGE) endorsed by the Royal College of Obstetricians & Gynaecologists (RCOG)[J]. Facts Views Vis Obgyn201911(1):5-25.
[28]
Adamina M, Andreou A, Arezzo A, et al. EAES rapid guideline: systematic review, meta-analysis, GRADE assessment, and evidence-informed European recommendations on appendicitis in pregnancy[J]. Surg Endosc202236(12):8699-8712.
[29]
Kuczkowski KM. The safety of anaesthetics in pregnant women[J]. Expert Opin Drug Saf20065(2):251-264.
[30]
American College of Obstetricians and Gynecologists′ Committee on Obstetric Practice, American Society of Anesthesiologists. ACOG Committee Opinion No. 775 Summary: Nonobstetric Surgery During Pregnancy[J]. Obstet Gynecol2019133(4):844-845.
[31]
Vasco Ramirez M, Valencia GC. Anesthesia for nonobstetric surgery in pregnancy[J]. Clin Obstet Gynecol202063(2):351-363.
[32]
吴亚芬,庹鹏,王寿平. 孕期非产科手术的围手术期管理[J/CD]. 中华产科急救电子杂志20209(3):189-192.
[33]
Minig L, Otaño L, Cruz P, et al. Laparoscopic surgery for treating adnexal masses during the first trimester of pregnancy[J]. J Minim Access Surg201612(1):22-25.
[34]
Babler EA. Perforative appendicitis complicating pregnancy[J]. JAMA1908LI(16):1310-1314.
[35]
Aggenbach L, Zeeman GG, Cantineau AE, et al. Impact of appendicitis during pregnancy: no delay in accurate diagnosis and treatment[J]. Int J Surg201515:84-89.
[36]
Abbasi N, Patenaude V, Abenhaim HA. Evaluation of obstetrical and fetal outcomes in pregnancies complicated by acute appendicitis[J]. Arch Gynecol Obstet2014290(4):661-667.
[37]
Tolcher MC, Fisher WE, Clark SL. Nonobstetric surgery during pregnancy[J]. Obstet Gynecol2018132(2):395-403.
[38]
Cheng V, Ashbrook M, Youssefzadeh AC, et al. Management for Acute Uncomplicated Appendicitis During Pregnancy: National Trends and Patient Outcomes[J]. Ann Surg2023278(6):932-936.
[39]
吴亚芬,庹鹏,刘近发,等. 孕期非产科手术87例围手术期管理及妊娠结局分析[J/CD]. 中华产科急救电子杂志20209(1):54-58.
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