评估尼日利亚阿巴卡利基东南部一家三级医院妇科急诊的处理结果

Amuche V. Nwafor, Odidika UgochukwuJoannes Umeora, A. C. Ikeotuonye, V. Obi, N. Adiele, Nkechinyere Onwe, B. Onwe
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摘要

背景:妇科急诊是急诊入院的常见原因。大多数急诊大多与妊娠有关,对妇女的生命和未来的生育事业构成威胁。因此,有必要对这些急症进行评估,以便为处理这些急症做好更充分的准备:这是一项为期10年(从2012年1月1日至2021年12月31日)的回顾性研究,研究对象是阿巴卡利基亚历克斯-埃克伍梅联邦大学教学医院(AEFUTHA)处理的妇科急症,对其处理情况和结果进行评估:AEFUTHA最常见的妇科急诊病因是流产,占69.1%,其中不全流产占70.8%,大多数采用人工真空吸引术,效果良好。宫外孕破裂是最常见的外科急诊,发生率为 7.1%,所有急诊都进行了开腹手术和部分输卵管切除术。妊娠滋养细胞疾病占妇科急诊的 2.0%。最常见的非妊娠相关妇科急症是急性盆腔炎,占 9.3%。其他妇科急症包括卵巢意外(2.9%)、异常子宫出血(3.9%)、妇科恶性肿瘤(2.3%)、性交裂伤(1.5%)、性侵犯(2.4%)和巴氏脓肿(0.2%)。影响结果的因素包括患者的年龄、婚姻状况和疾病类型,这些因素均有统计学意义(P<0.05):结论:妇科急症的治疗效果最佳。死亡率为 1.3%,其中妇科恶性肿瘤占 81.4%。如果能得到及时、准确的诊断和治疗,预后通常会很好。
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Evaluating the management outcomes of gynaecological emergencies at a tertiary hospital, Abakaliki Southeast, Nigeria
Background: Gynaecological emergencies are common causes of emergency hospital presentation/admission. Majority of the emergencies are mostly pregnancy related and pose threat to two lives as well as the women’s future reproductive careers. There is therefore need to evaluate them to make better preparations in managing them. Methods: This was a 10 year (from 01 January 2012 to 31 December 2021) retrospective study of gynaecological emergencies managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), evaluating their management and outcomes. Results: The commonest cause of gynaecological emergency at AEFUTHA was miscarriage accounting for up to 69.1% out of which incomplete miscarriage contributed 70.8% and majority had manual vacuum aspiration with good outcome. Ruptured ectopic pregnancies were the commonest surgical emergencies with the incidence of 7.1% and all had laparotomy and partial salpingectomy. Gestational trophoblastic diseases accounted for 2.0% of gynaecological emergencies. The commonest non-pregnancy related gynaecological emergency was acute pelvic inflammatory diseases which accounted for 9.3% of cases. Other gynaecological emergencies reviewed were ovarian accidents (2.9%), abnormal uterine bleeding (3.9%), gynaecological malignancies (2.3%), coital laceration (1.5%), sexual assault (2.4%) and Bartholin’s abscess (0.2%). Factors that affected the outcome were the age of the patients, marital status and disease type and were statistically significant (p<0.05). Conclusions: Management outcomes of gynaecological emergencies were optimum. Mortality occurred in 1.3% of cases, with gynaecological malignancies accounting for 81.4%. There is usually a good prognosis when prompt, accurate diagnosis and treatment are administered.
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