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1 病例介绍 患者,28岁,剖宫产术后2月余,仍有阴道流血,伴持续性腹痛及低热于1995年6月22日入院。患者孕、产、妊娠39~(+4)周临产后住某院,因胎心率一度变慢,行剖宫产术,胎儿娩出顺利,胎盘人工剥离,术中未发现异常。术后伤口愈合好,但体温波动在39℃左右,血白细胞6.6～ 8.4×10~9/L,中性0.75～0.88,给予抗感染治疗,产后10天体温仍为38.3℃。B超检查示:宫腔内见6.2cm×7.3cm增强光团,当日行剖宫术,探查宫腔有14cm,前壁有4cm×4cm硬度突起感,考虑为子宫内膜炎,继续抗感染治疗,于5月1日体温正常出院。3天后患者因下腹部疼痛加剧、发热再次入某院,妇科检查子宫体相当于孕3月余大小,前壁有突起,质硬,拟诊为产褥热合并子宫肌瘤,再次抗感染治疗无效而转入我院。
1 case description The patient, 28 years old, more than 2 months after cesarean section, there is still vaginal bleeding, with persistent abdominal pain and fever in hospital on June 22, 1995. Patients with pregnancy, pregnancy and pregnancy 39 ~ (+4) weeks postpartum living in a hospital, as a result of fetal heart rate was slowed down, cesarean section, the fetus delivered smoothly, placental abruption, no abnormalities were found. Postoperative wound healing, but the body temperature fluctuations at about 39 ℃, white blood cells 6.6 ~ 8.4 × 10 ~ 9 / L, neutral 0.75 ~ 0.88, given anti-infective therapy, 10 days postpartum body temperature was still 38.3 ℃. B-ultrasound showed: intrauterine see 6.2cm × 7.3cm enhanced photophosphere, the day of cesarean section, exploration of the uterine cavity 14cm, 4cm × 4cm anterior wall protruding sense of hardness, consider the endometritis, continue anti-infection Treatment, body temperature in May 1 normal discharge. 3 days after the patient due to lower abdominal pain intensified fever again into a hospital, gynecological examination of the uterus equivalent to more than three months pregnant size, the anterior wall of the protuberance, hard, to be diagnosed with puerperal fever with uterine fibroids, anti-infection treatment again Invalid and transferred to our hospital.