青春期女性急性盆腔痛的评估
- Authors
- Kathleen Brown, MD
Kathleen Brown, MD
- Associate Professor of Pediatrics and Emergency Medicine
- The George Washington University School of Medicine
- June A Lee, MD
June A Lee, MD
- Assistant Professor of Pediatrics and Emergency Medicine
- New York Presbyterian-Weill Cornell Medical Center
- Section Editor
- Stephen J Teach, MD, MPH
Stephen J Teach, MD, MPH
- Section Editor — Pediatric Signs and Symptoms
- Professor of Pediatrics and Emergency Medicine
- George Washington University School of Medicine and Health Sciences
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
- Translators
- 叶菱, 主治医师
叶菱, 主治医师
- 四川大学华西医院麻醉科
引言
很多疾病都可导致或促成青春期女性盆腔痛。盆腔痛可以定义为任何脐下腹痛或者下腹痛。随着女性进入青春期并开始有月经后，盆腔痛的鉴别诊断范围大增。
本专题将总结因盆腔痛就诊的青春期女性的鉴别诊断和处理方法，着重于妇产科方面。腹痛的胃肠道和泌尿系统原因将单独作更详细的讨论。 (参见“儿童及青少年急性腹痛的病因”)
年龄较大的女性急性盆腔痛的评估也将单独讨论。 (参见“女性急性盆腔痛的评估”)
鉴别诊断
青春期前女孩的盆腔疼痛最常涉及胃肠道或泌尿系统。然而，妇产科情况越来越普遍地成为盆腔痛病因，尤其是在青春期后期。表中罗列了青春期女性急性盆腔痛的妇产科原因(表 1)。
危及生命的疾病 — 妊娠的并发症(如异位妊娠、急性胎盘早剥、子宫破裂)构成了青春期女性盆腔痛最常见的危及生命的妇产科病因。盆腔痛的胃肠道病因如果导致腹膜炎和脓毒症，也可危及生命。其中，阑尾炎最常见，将在本文讨论。其他疾病(如脓肿和肠梗阻)见其他专题。 (参见“儿童及青少年急性腹痛的病因”，关于‘危及生命的病因’一节)
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