异位妊娠早期诊断方法研究  

Early Diagnosis of Ectopic Pregnancy

作　　者：方秀莲[1] 宋茜[1] 黄诚刚[2] 王晓敏[3] 

机构地区：[1]孝感市中心医院妇科,湖北孝感432100 [2]孝感市中心医院核医学科,湖北孝感432100 [3]孝感市中心医院心超科,湖北孝感432100

出　　处：《护理学杂志》2005年第10期3-6,共4页

基　　金：湖北省重大科学技术成果(EK040563)

摘　　要：目的探讨异位妊娠(EP)与早早孕鉴别诊断的特征性依据,避免误诊误治。方法对132例疑似异位妊娠妇女按诊断分为A(EP流产,51例)、B(EP孕囊破裂,14例)、C(EP行保守治疗成功,28例)、D(宫内正常妊娠,26例)及E(宫内妊娠流产,行诊刮术,13例)五组,均行子宫内膜厚度、β人绒毛膜促性腺激素(β-HCG)及孕酮值检测。结果D组子宫内膜厚度及孕酮值显著大于A、B组(均P<0.01),子宫内膜厚度、β-HCG及孕酮值大于C、E组(P<0.05,P<0.01);A、B组β-HCG、子宫内膜厚度值与E组比较,差异有显著性意义(均P<0.01),而孕酮值差异无显著性意义(均P>0.05)。结论孕酮不足是导致宫内外妊娠流产的主要原因;βHCG、孕酮值的测定结合子宫内膜厚度测量能预测妊娠的趋向、提示妊娠的着床部位,防止误诊误治。护理中注意检测前指导、密切观察腹痛情况、规范采集血标本,以确保患者安全。Objective To explore the specifi c indicators for differentiating ectopic pregnancy from the very early pregnancy to avoid misdiagnosis. Methods One hundred and thirty-two wome n suspicious of ectopic pregnancy were divided into 5 groups on the basis of th eir diagnoses: group A (ectopic pregnancy abortion, n=51 ), group B (ectopic pregnancy rupture, n=14), group C (ectopic pregnancy successfully cured wit h conservative treatment, n=28), group D (normal pregnancy in uterus, n= 26) and group E (abortion after pregnancy-in-uterus with diagnostic curettage , n=13 ). The endometrial thickness, β-HCG and progesterone were determin ed in the patients. Results The endometrial thickness and prog esterone level in group D were significantly greater than those of groups A and B (P<0.01, for all); the endometrial thickness, β-HCG level and proges terone in group D were higher than those of groups C and E (P<0.05, P<0. 01, respectively). There was a significant difference in the level of β-HCG an d the endometrial thickness between groups A, B and group E ( P<0.01, for a ll), but no significant differences were found in in the level of progesterone b etween them (P>0.05, for all) .Conclusion The low level of p rogesterone is the main reason for abortion of pregnancy in uterus and ectopic p regnancy. The determination of β-HCG and progesterone and the measurement of e ndometrial thickness can help predict pregnancy outcomes and imbedding location, which can prevent the misdiagnosis and faulty treatment. During nursing care, a ttention should be paid to the guidance of patients before the tests, occurr ence of abdominal pain and methods of blood sample collection to insure the safe ty of pregnant patients.

关 键 词：诊断方法 妊娠早期 β-人绒毛膜促性腺激素 子宫内膜厚度 β-HCG 误诊误治 妊娠流产 孕酮值 采集血标本 鉴别诊断 异位妊娠 妊娠妇女 孕囊破裂 保守治疗 正常妊娠 0.05 厚度测量 着床部位 注意检测 显著性 特征性 早早孕 

分 类 号：R169.42[医药卫生—公共卫生与预防医学] R446.61