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妊娠合并坏疽性阑尾炎致感染性休克、足月顺产一例

  • 杨君丽 ,
  • 贺芳 ,
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  • 510150 广州医科大学附属第三医院妇产科 广州重症孕产妇救治中心 广东省产科重大疾病重点实验室
通信作者:贺芳,Email:

Copy editor: 周泽纯

收稿日期: 2022-05-31

  网络出版日期: 2023-06-06

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未经授权,不得转载、摘编本刊文章,不得使用本刊的版式设计,除非特别声明,本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。本刊为电子期刊,以网刊形式出版。

Pregnancy complicated with gangrenous appendicitis causing septic shock and full-term vaginal delivery: a case report

  • Junli Yang ,
  • Fang He ,
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Received date: 2022-05-31

  Online published: 2023-06-06

Copyright

Copyright by Chinese Medical Association No content published by the journals of Chinese Medical Association may be reproduced or abridged without authorization. Please do not use or copy the layout and design of the journals without permission. All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.

摘要

患者32岁,孕3产1,因"停经30+6周,右侧腹痛11 d,发热1+ d,头痛半天"于2021年9月15日转诊入广州医科大学附属第三医院。患者末次月经2021年2月11日,预产期11月18日,孕期定期产检,未见异常。9月4日晚(孕29+周)患者进食自炒米粉、油炸花生米后出现右上腹部疼痛,呈持续性,中度,伴呕吐胃内容物2次,非喷射状,无畏寒、发热、腹泻等不适,无阴道流血、流液,自觉胎动如常,右上腹部疼痛逐渐转为全腹痛,遂于外院急诊入院,查白细胞13.9×109/L,中性粒细胞百分数(neutrophil percentage,NEU%)74.1%,血红蛋白116 g/L,行产科超声、泌尿系及阑尾超声检查未见异常,考虑妊娠合并急性阑尾炎?9月5日至12日予头孢曲松2 g每天1次抗感染治疗,期间患者自觉腹痛好转,9月9日复查阑尾超声未提示异常,12日复查感染指标较前升高,遂13、14日改用哌拉西林他唑巴坦1 g(1次/12 h)抗感染治疗,14日患者首次出现发热,体温最高39.5 ℃,伴寒战,持续约20 min,予布洛芬处理后体温逐渐下降,再次复查阑尾超声未提示异常,15日患者开始头痛,呕吐胃内容物1次,测体温35.7 ℃,血压78/48 mmHg(1 mmHg=0.133 kPa),脉搏85次/min,呼吸22次/min。查体再次出现右下腹压痛,考虑感染性休克,因病情危重,予补液、去甲肾上腺素升压等对症处理同时转诊至我院。患者既往体健,否认高血压、糖尿病等慢性病史;2012年孕足月顺产一胎,2018年孕6+月因"胎儿肾积水、羊水过少"行引产术。

本文引用格式

杨君丽 , 贺芳 . 妊娠合并坏疽性阑尾炎致感染性休克、足月顺产一例[J]. 中华产科急救电子杂志, 2023 , 12(01) : 54 -56 . DOI: 10.3877/cma.j.issn.2095-3259.2023.01.012

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