腹腔妊娠6例临床分析  

作　　者：蔡瑞贤[1] 戴婉波[1] 覃小红[1] 

机构地区：[1]广州医学院附属深圳市沙井医院产科,518104

出　　处：《中国社区医师（医学专业）》2010年第14期83-84,共2页

摘　　要：目的:探讨腹腔妊娠的早期诊断及临床治疗效果。方法:回顾性分析1995年1月～2009年1月腹腔妊娠患者6例资料。并将4例中晚期腹腔妊娠患者先取出胎儿,胎盘与大网膜、肠管及子宫后壁紧密相连而无法分离时,应于脐带根部近端结扎,术后要预防感染和止血治疗,同时单次肌注甲氨喋呤50mg,口服米非司酮150mg/日,共3天。对早期腹腔妊娠2例直接切除创面,术后防感染治疗。结果:6例均治愈出院。随访21天,早期腹腔妊娠血HCG阴性,中晚期4例3个月血HCG恢复正常,半年复查B超未见腹腔包块。结论:临床症状、妇产科及早期B超检查均能提高腹腔妊娠确诊率。一经确诊,要及早剖腹探查术,视胎盘附着部位、胎儿是否存活及死胎时间决定是否保留胎盘。Objective：To investigate the early diagnosis of abdominal pregnancy, and treatment. Methods：From January 1995 to January 2009 abdominal pregnancy occurred in 6cases, preoperative diagnosis of clinical symptoms, signs, and B mode ultrasound laparotomy in the diagnosis. Surgical in four cases of late abdominal pregnancy, first picked out the fetus, placenta and the omentum, intestine, and closely linked to the posterior wall of the uterus can not be separated from roots at the proximal ligation of the umbilical cord, after strengthening the prevention of infection, bleeding therapy, while a singleintramuscular injection of methotrexate 50 rag, oraladministration of in non Division one 150mg/d, a total of 3d, early abdominal pregnancy two cases of direct excision wound infection happned after treatment. Results： 6patients were cured. Followed up for 21 days of early abdominal pregnancy, HCGnegative blood, four cases of middle and late March of blood HCG returned to normal, semiannual review of Bno abdominal mass. Conclusion： The clinical symptoms, gynecological examination and early B ultrasound can improve the diagnosis rate of abdominal pregnancy, once diagnosed, early laparotomy, depending on the placental site, fetal survival and stillbirth time to decide whether to keep the placenta.

关 键 词：腹腔妊娠 剖腹探查术 胎盘治疗 

分 类 号：R714.223[医药卫生—妇产科学]