| ObjectiveEndometriosis is a common disease in women of childbearing age.The cases of ovarian endometriotic cyst complicated with infection in patients with endometriosis are reported to be increasing and rising year by year.When ovarian endometriosis cyst is complicated with infection,the severity of infection will be high,and the clinical symptoms are not special.Conservative treatment is not effective and the operation is difficult.At present,no standardized clinical treatment system have been established for endometriosis complicated infection at home and abroad.By collecting inpatients diagnosed with endometriosis complicated with infection in the Second Affiliated Hospital of Shantou University Medical College,the clinical features,diagnosis and treatment prcesee as well as postoperative follow-up and recurrence were retrospectively analyzed.The purpose of this study was to explore the clinical characteristics and treatment of ovarian endometriosis complicated with infection.It will provide clinical ideas for the standardized diagnosis and treatment of this kind of diseases.Methods and materials606 cases diagnosed with endometriosis in our hospital from March 2012 to March 2021 were retrospectively analyzed,and interference cases were excluded.Among them,418 cases were diagnosed with ovarian endometriosis.Through the investigation one by one,11 cases were finally diagnosed with ovarian endometriosis complicated with infection.In this paper,11 patients were taken as the object of study.Their clinical characteristics,diagnosis and treatment process and postoperative recovery were analyzed,and make an in-depth analysis combined with the progress of the literature.Results1.Among patients with ovarian endometriotic cysts,the incidence of coinfection is on the rise,with incidences of 2.26%,1.27% and 4.76% per three years in 2012-2015,2015-2018 and2019-2021,respectively.2.Clinical features: 1)General condition: the average age of 11 patients was(36.36 ± 6.10)years old,10 married patients had sexual life,1 female denied sexual life without marriage and childbearing,4 cases had history of gynecological operation and 4 cases had history of dysmenorrhea.2)Clinical symptoms: 9 cases of abdominal pain(81.82%),4 cases of pelvic mass(36.36%)and 2 cases of fever(18.18%).3)physical signs: abdominal tenderness in 6 cases(54.55%),peritoneal irritation sign in only 2 cases(18.18%);gynecological examination: double palpation and pelvic mass in 8 cases(72.73%),including pelvic mass tenderness in 4 cases;uterine tenderness in 5 cases(45.45%);cervical pain and rocking pain in 3 cases(27.27%).4)Laboratory examination: the total leukocyte count increased in 7 cases(63.63%),hypersensitive C-reactive protein increased in 6 cases,elevated in 4 cases(66.67%),CA125 test in 10 cases,increased in 4 cases(40.00%).5)Imaging examination: pelvic space occupying lesions were found by pelvic color ultrasonography,"ground glass" mixed echo in 2 cases and mixed echo in3 cases,but the nature of the mass was not described in detail.3..The course of treatment: 1 case was treated by ultrasound-guided puncture biopsy and drainage,10 cases were treated by operation,and there was significant difference in postoperative bleeding and exhaust time between laparoscopy group and laparotomy group.The staging of endometriosis(ASRM staging)was retrospectively analyzed in 7 cases of stage Ⅲand 3 cases of stage Ⅳ.4 cases were treated with antibiotics before operation and 11 cases were treated with antibiotics after operation.Conclusion1.The clinical characteristics of ovarian endometriotic cyst complicated with infection are not typical,which are similar to the symptoms of pelvic inflammatory disease.The following abdominal pain is mainly acute or chronic acute attack,may be accompanied by fever;physical signs can be found lower abdominal pain tenderness;gynecological examination: pelvic mass and mass tenderness.Laboratory examination showed increased inflammatory indicators;color ultrasound may find typical ovarian endometriosis cyst;need to be combined with symptoms,signs,auxiliary examination comprehensive judgment.Therefore,the clinical cognition is low,the misdiagnosis rate is high,and the accuracy of initial diagnosis is low.2.Once considering ovarian endometriosis cyst;complicated with infection,the effect of simple antibiotic treatment is not good,and the main way of treatment is more active operation.Laparoscopic surgery is recommended,careful conversion to laparotomy.The choice of antibiotics after operation is consistent with the use of pelvic inflammatory diseases.The choice of antibiotics is consistent with the use of pelvic inflammatory diseases... |
PDF Full Text Request