Clinical Analysis Of Hospitalized Patients With Pelvic Inflammatory Disease

Objective:To investigate the diagnosis and treatment of hospitalized patients with pelvic inflammatory disease in Shanxi Dayi Hospital.Methods:To retrospectively analyze the clinical data of 117 patients with pelvic inflammatory disease who were hospitalized in Shanxi Dayi Hospital from January 2012 to January2019,analyze their clinical manifestations,laboratory tests and imaging examinations,and assess the severity of the disease while diagnosing the disease,and analyze its treatment.Results:117 patients with PID were divided into non-systemic inflammatory response syndrome patients(SIRS,71 patients),SIRS patients(31 patients),multiple organ dysfunction syndrome patients(MODS,12 patients)and septic shock patients according to the severity of the disease.(3 cases).Comparing CRP and plasma D-dimer levels in non-SIRS patients and SIRS patients(include MODS patients and Septic shock patients),plasma D-dimer and CRP levels were significantly higher in SIRS patients than in non-SIRS patients,and the difference was statistically significant(P<0.05).Comprehensive treatment: 11% of patients with non-SIRS(8/71),16% of patients with SIRS(5/31),100% of patients with MODS(12/12)and 100% of patients with septic shock(3/3)underwent comprehensive treatment.Use of antibacterial drugs: The pathogens of PID are mostly mixed infections of aerobic bacteria,anaerobic bacteria,chlamydia and chlamydia,so follow thebroad-spectrum,experience,timely and individualized treatment principles for anti-infective treatment.Moxifloxacin and cefuroxime have poor treatment results,with high replacement rates of 21% and 15%,respectively.The replacement rate of cefoperazone sulbactam and piperacillin tazobactam sodium is low,both are 5%.Surgical treatment: The surgical rate is directly proportional to the severity of the patient's condition and the size of the abscess.The more severe the condition,the larger the abscess and the higher the surgical rate.Severe patients with general treatment and anti-infective treatment improve the general situation(or at the same time)active preoperative preparation,early surgery.Surgical methods: 84% of patients underwent laparoscopic surgery(70/83),5% of patients underwent laparotomy(4/83),and 11% underwent laparotomy(9/83).59% of patients underwent bilateral salpingectomy(49/83),24% underwent lesion resection(20/83),2.4% underwent partial salpingectomy(2/83),and 14.6% underwent abscess drainage(12/83).Four patients relapsed within 1 year after surgery,2 patients underwent one-stage salpingectomy,and 2 patients underwent abscess drainage.Bacterial culture results: Among 117 PID patients,103 patients underwent bacterial culture,83 patients underwent cervical secretion culture,41% were positive(34/83),and most were Escherichia coli and Enterococcus faecium;46 In the case of simultaneous cervical secretions and pus bacterial culture,70% of the culture results were consistent(8cases were positive,24 cases were negative),and Escherichia coli was the most.Patients with diabetes: 12 patients with diabetes,3 patients with SIRS(25%),4patients with MODS(33%),and 1 patient with septic shock(8.3%).Conclusion:The diagnosis of the PID should be based on the minimum diagnostic criteria,additional criteria,and specific criteria,and the severity of the condition should be assessed for stratified diagnosis and stratified treatment.According to the severity of the patient's condition and the size of the abscess,the timing of the operation is grasped,and after the general treatment is improved(or at the same time),the surgical treatment is actively performed,and the infection is removed asmuch as possible.The aerobic culture of cervical secretions can reflect the infection of aerobic bacteria in the pelvic cavity to a large extent.When the culture results are negative,the treatment of anaerobic bacteria should be emphasized.CRP and D-dimer values can be used as indicators to assess the severity of the condition.For patients with PID,it is necessary to pay attention to whether or not to have diabetes;patients with diabetes with diabetes should pay attention to the treatment of diabetes.