| Objective:Analyze the basic characteristics of rupture of the corpus luteum and explore the influencing factors of the choice of treatment.Methods:A total of 257 patients with ruptured corpus luteum were admitted to the gynecology department of the Affiliated Hospital of Qingdao University from February 2010 to June2019.Divided into conservative treatment group and surgical treatment group according to different treatment methods,comparing the differences between physical examination,ultrasound type,initial hemoglobin value,peritoneal fluid volume(depth of rectum and uterine recession),maximum diameter of mass and hospitalization days;Taking heart rate,body mass index(BMI),initial hemoglobin value,length of hospital stay,pain time,age,blood pressure,and maximum diameter of mass as independent variables,taking the volume of peritoneal effusion as the dependent variable,Spearman correlation analysis was applied And linear regression test to analyze the correlation;the conservative treatment group was divided into oral pelvic inflammatory soup group and non-oral pelvic inflammatory soup group according to whether oral pelvic inflammatory soup group was compared.Abdominal mass,peritoneal effusion absorption and abdominal pain relief were compared between the two groups The difference between the two;the Wilcoxon rank sum test or t test was also used to compare the difference in the maximum diameter of the mass,the amount of peritoneal effusion and the time of pain between the two types of corpus luteum rupture.Results:1.257 patients were enrolled,with an average age of 27.84 ± 7.07 years,151(58.75%)from 21 to 30 years old;142(55.25%)had no obvious incentives;257(100%)were all treated with abdominal pain;physical examination It showed that there were 192cases(74.71%)of lower abdominal tenderness,17 cases(6.62%)of abdominal muscle tension,220 cases(85.60%)of tenderness in the affected area,93 cases(36.19%)of lower abdominal rebound tenderness,and mobile dullness 83 cases(32.30%),124 cases(48.25%)with affected mass,125 cases(48.64%)with cervical pain,149 cases(57.98%)with normal hemoglobin,89 cases(34.63%)with mild anemia;142 cases of type 1 corpus luteum rupture(55.25%),115 cases of type 2 corpus luteum rupture(44.75%).2.Compared with the conservative treatment group,the surgical treatment group had an initial hemoglobin value,peritoneal effusion volume,and maximum diameter of the mass [respectively 116(109-125)vs.107(100-120)g / L,2.1(1.5-3.0)vs.2.7(1.9-3.9)cm,4.2(3.1-5.8)vs.7.2(5.4-8.7)cm,3(2-4)vs.4(3-4)d],the difference is statisticallysignificant(P <0.05);compared with type II corpus luteum rupture,Type I corpus luteum rupture has statistically significant differences in the maximum diameter of the mass and the volume of peritoneal fluid(6.199 ± 2.158 vs.7.852 ± 1.970 cm,2.634 ± 1.319 vs.3.103± 1.433 cm,respectively)(P <0.05)The heart rate,the maximum diameter of the mass have a significant positive correlation with the amount of peritoneal effusion(r = 0.141,P= 0.024;r = 0.289,P <0.001),the initial hemoglobin value,BMI and the peritoneal effusion have a significant negative correlation(r =-0.290,r =-0.236,P <0.001);In the surgical treatment group,the heart rate was 85.90 ± 12.69 beats / min,the maximum diameter of the mass was 7.12 ± 2.21 cm,the initial hemoglobin value was 109 ± 15.71g/ L,and BMI19.34 ± 2.34.3.Treatment methods include conservative treatment and surgical treatment;103cases(40.08%)choose conservative treatment,154 cases(59.92%)choose surgical treatment,and 115 cases(74.68%)undergo laparoscopic corpus luteum cystectomy.Among the influencing factors of the choice of treatment methods,the difference between the two groups of lower abdominal rebound tenderness,affected mass,mobile dullness and cervical lifting pain was statistically significant(P <0.05);oral pelvic inflammatory decoction group and non-oral pelvic The Yantang group had no statistically significant difference in abdominal effusion,abdominal mass absorption and abdominal pain relief(P> 0.05).Conclusion:1.Rupture of the corpus luteum usually occurs in young women,and there is no obvious cause.The first symptom is sudden abdominal pain on one side,and other clinical manifestations are not typical.Most of them have type I corpus luteum rupture and the initial hemoglobin is normal.2.Faster heart rate(> 85 beats / min),larger mass diameter(> 7cm),lower initial hemoglobin(<109g / L),and lower BMI(<19),the rupture type I,more peritoneal effusion is more suitable operation treatment;The larger the maximum diameter and the lower the BMI,the more peritoneal effusion,the lower the initial hemoglobin value and the faster the heart rate.3.The treatment methods mainly include conservative treatment and surgical treatment.The operation method is mainly laparoscopic corpus luteum cystectomy;the influencing factors of treatment choice include lower abdominal rebound tenderness,affected mass,mobile dullness and cervical pain. |
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