多发性子宫肌瘤和肠憩室患者的管理策略特点

K. O. B., T. Yu. V., Lipatov I. S.
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摘要

本研究的目的是研究一名患有多发性子宫肌瘤和肠道憩室的患者的治疗策略特点。在对这一临床病例进行分析时,发现该病例需要进行手术治疗。由于大肠憩室引起的严重炎症和腹腔粘连,导致术中损伤回肠这一并发症。回肠出现明显的炎症变化并形成憩室病,随后肠道内出现大量粘连,但手术前并未确诊。诊断较晚的原因可能是患者的临床症状轻微,没有明显的临床表现。患者下腹部的隐痛可能是由于子宫肌瘤过大所致,也可能是憩室疾病的临床表现。在计划手术期间及时发现了回肠损伤,并及时进行了修复。术后的管理策略是正确的;所有的诊断和治疗预约都得到了完整的执行,这使得该名妇女在术后第 14 天就可以出院,情况令人满意。就憩室疾病的诊断向患者提出了建议,旨在防止其恶化和并发症的发生。如果患者患有憩室病,即使表现轻微且无症状,也有必要假定其可能发展为盆腔粘连性疾病,并预防可能出现的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
FEATURES OF MANAGEMENT TACTICS FOR A PATIENT WITH MULTIPLE UTERINE FIBROIDS AND INTESTINAL DIVERTICULOSIS
The purpose of this study is to study the features of management tactics for a patient with multiple uterine fibroids and intestinal diverticulosis. When analyzing this clinical case, it was revealed that surgical intervention was indicated in this case. A complication, intraoperative injury to the ileum, occurred due to severe inflammation and adhesions of the abdominal cavity caused by diverticulosis of the large intestine. The presence of pronounced inflammatory changes in the ileum with the formation of diverticular disease, followed by the development of a massive adhesive process in the intestine, was not diagnosed before surgery. Late diagnosis may be due to the patient having a mild, asymptomatic clinical picture of the disease and the absence of pronounced clinical manifestations. The patient's nagging pain in the lower abdomen could be due to either the large size of uterine fibroids or be a manifestation of the clinical picture of diverticular disease. The ileal injury was detected in a timely manner, during a planned operation, and repaired in a timely manner. The management tactics in the postoperative period were correct; all diagnostic and therapeutic appointments were carried out in full, which allowed the woman to be discharged on the 14th day of the postoperative period in satisfactory condition. The patient was given recommendations in connection with the diagnosis of diverticular disease, aimed at preventing its progression and development of complications. It is necessary, if a patient has diverticulosis, even with minor manifestations and an asymptomatic course, to assume the possibility of developing pelvic adhesive disease and to prevent the development of possible complications.
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