盆腔放线菌病3例报告及文献分析

Pelvic Actinomycosis: Report of Three Cases and Literature Analysis

摘要: 目的：探讨盆腔放线菌病的病因、临床表现、诊断及治疗方法，加深对该病的认识和提升对该病的临床诊治能力。方法：对本院收治的3例盆腔放线菌病患者的病例特点进行分析，同时复习相关文献。结果：3例患者均有腹痛表现，影像学表现均不典型，经抗生素及手术治疗后均未复发。结论：盆腔放线菌病是一种主要由放线菌引起的慢性非传染性疾病，宫内节育器(IUD)为常见的高危因素；其症状不典型，易与发生在盆腔的炎性疾病及肿瘤混淆；病灶或穿刺脓液中找到硫磺颗粒可诊断该病；药物治疗为治疗盆腔放线菌病首选，首选大剂量长疗程青霉素类药物，手术治疗也是治疗放线菌病盆腔脓肿的手段之一；与其他部位的放线菌病相比，盆腔放线菌病的总体预后较好。

Abstract: Objective: To explore the etiology, clinical manifestations, diagnosis and treatment of pelvic actinomycosis, deepen the understanding of this disease and improve the ability of clinical diagnosis and treatment of this disease. Methods: The characteristics of three patients with pelvic actinomycosis admitted to our hospital were analyzed, and related literatures were reviewed. Results: All three patients had abdominal pain with atypical imaging manifestations and no recurrence after antibiotic and surgical treatment. Conclusion: Pelvic actinomycosis is a chronic noninfectious disease mainly caused by actinomycosis. The intrauterine device (IUD) is a common high-risk factor. Its symptoms are not typical and are easily confused with inflammatory diseases and tumors occurring in the pelvic cavity. Sulfur particles found in lesions or punctured pus can diagnose the disease. Drug treatment is the first choice for the treatment of pelvic actinomycosis, the first choice of large dose and long course of penicillin drugs, surgical treatment is also one of the means to treat pelvic actinomycosis abscess; pelvic actinomycosis has a better overall prognosis than other sites of actinomycosis.