摘要
目的通过报道一例顽固性骶前脓肿病例,结合以往文献进行分析,为今后相关病例诊治提供临床经验。方法对笔者所在医院收治的一例顽固性骶前脓肿的诊疗过程进行分析与讨论。结果本例骶前脓肿患者病程长,病灶范围大,不排除恶变可能,综合评估后采用经腹腔镜入路盆腔廓清术治疗,术后病理明确诊断为恶性肿瘤,术后积极给予补液、抗炎、放化疗等治疗,严密随访,现恢复良好,近期影像学检查未见脓肿及肿瘤复发。结论骶前脓肿临床表现典型,但手术难度大,治疗往往不彻底,脓肿容易迁延不愈。针对病程长,脓肿顽固的患者,需警惕恶变可能。术前应全面评估,选择合理的手术方式;术中应根据情况适当扩大手术范围,彻底清除脓肿,术后应规范管理,促进康复。
Objective To report a case of intractable presacral abscess in our hospital,and analyze the previous literature,so as to provide clinical experience for the diagnosis and treatment of related cases in the future.Methods A case of intractable presacral abscess in our hospital was analyzed and discussed.Results This patient with presacral abscess had a long course of disease and a wide range of lesions,and the possibility of malignant transformation was not ruled out.After comprehensive evaluation,the patient was treated with laparoscopic pelvic exenteration,and the pathological diagnosis was confirmed as malignant tumor.After the operation,she was actively treated with fluid replacement,anti-inflammatory,radiotherapy and chemotherapy.She was followed up closely,and now recovered well.No abscess or tumor recurrence was found in recent imaging examination.Conclusion The clinical manifestations of presacral abscess are typical,but the operation is difficult,the treatment is often incomplete,and the abscess is easy to persist.For patients with long course of disease and stubborn abscess,we should be alert to the possibility of malignant transformation.Comprehensive preoperative evaluation should be made to select a reasonable surgical method.During the operation,the scope of operation should be appropriately expanded according to the situation,abscess should be thoroughly removed,and postoperative management should be standardized to promote rehabilitation.
作者
黄山
孔伟
鲍明月
徐惠成
HUANG Shan;KONG Wei;BAO Mingyue;XU Huicheng(Department of Gynecology,Guiqian International General Hospital,Guiyang,Guizhou 550000,China)
出处
《手术电子杂志》
2022年第6期68-71,共4页
Electronic Journal of Medical Operations
关键词
骶前脓肿
盆腔廓清术
腹腔镜
手术治疗
presacral abscess
pelvic exenteration
laparoscopic
surgical treatment
