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我自1986年5月～1996年10月共收治出血性输卵管炎24例,误诊18例,误诊率为75％。分析如下。 1 临床资料 本组18例中,年龄最小21岁,最大42岁,平均30.4岁,均为已婚女性,有人工流产史14例。置宫内节育器3例,输卵管结扎1例。18例均有腹痛,且为突然发作,伴肛门坠胀感,阴道流血8例,停经史6例,恶心呕吐及发热4例,18例均有腹部压痛及不同程度的反跳痛,移动性浊音10例,休克2例。妇科检查12例,均有后穹窿饱满和宫颈举痛,4例触及附件包块。行后穹窿穿刺6例,腹腔穿刺6例,均抽出不凝固血液。B超检查12例,均提示盆腔内积液,4例提示附件包块。7例查尿或血HCG均为阴性,Hb40～90g/L,WBC6.0～16×10~9/L。 误诊为宫外孕12例,卵巢肿瘤蒂扭转2例,急性阑尾炎4例。18例均经剖腹探查,见腹腔内出血量达500～2200ml。输卵管均有不同程度充血、水肿、增粗,伞端可见血
From May 1986 to October 1996 I treated 24 cases of hemorrhagic salpingitis, misdiagnosed 18 cases, the misdiagnosis rate was 75%. analyse as below. 1 Clinical data The group of 18 cases, the youngest 21 years old, the maximum 42 years old, average 30.4 years old, are married women, abortion history of 14 cases. IUD installed in 3 cases, tubal ligation in 1 case. Eighteen patients had abdominal pain, sudden onset, drooping with anus, vaginal bleeding in 8, history of menopause, nausea and vomiting in 4, fever in 18 and varying degrees of rebound tenderness, mobility Voiced in 10 cases, shock in 2 cases. Gynecological examination in 12 cases, both posterior fornix and cervical pain, 4 cases of accessorial mass. After the culdocentesis in 6 cases, abdominal puncture in 6 cases, were extracted without coagulation blood. B-ultrasound in 12 cases were prompted pelvic fluid, 4 cases prompted the annex mass. 7 cases of urine or blood HCG were negative, Hb40 ~ 90g / L, WBC6.0 ~ 16 × 10 ~ 9 / L. Misdiagnosed as ectopic pregnancy in 12 cases, 2 cases of ovarian tumors torsion, 4 cases of acute appendicitis. 18 cases were laparotomy, see intraperitoneal hemorrhage amounted to 500 ~ 2200ml. Tubal have varying degrees of congestion, edema, thickening, umbrella-side visible blood