经阴道穿刺治疗宫内外同时妊娠8例临床分析  

Clinical analysis of heterotopic pregnancy patients managed by transvaginal aspiration

作　　者：刘见桥[1] 龙晓林[1] 黄青[1] 许海燕[1] 吴乙旋[1] 刘明星[1] 李冰[1] 肖国宏[1] 

机构地区：[1]广州医学院第三附属医院生殖医学中心,广东广州510150

出　　处：《中国实用妇科与产科杂志》2011年第9期695-697,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：广东省科技计划项目(2010B031600299)

摘　　要：目的探讨经阴道穿刺治疗宫内外同时妊娠(HP)的适应证、时机的选择及预后。方法回顾性分析2003年1月至2010年6月在广州医学院第三附属医院生殖医学中心经阴道穿刺治疗HP8例患者的临床特点、住院时间和妊娠结局。结果 8例HP患者经阴道穿刺治疗,其中6例经阴道穿刺抽吸异位妊娠胚胎,2例吸出异位妊娠胚胎后再注射50%葡萄糖2mL。治疗时孕龄43～68d,异位妊娠囊直径15～32mm;手术时间(10.0±1.8)min,住院天数(8.25±0.89)d。1例在治疗后4h因输卵管破裂发生失血性休克,行输卵管切除术,术后3d宫内胚胎停止发育而行清宫术,6例足月妊娠分娩,1例孕36周早产;新生儿均存活,体重(3166.7±272.5)g,无新生儿窒息和畸形。结论对于诊断明确的HP患者,如果孕周<8周,病变输卵管未破裂,无明显的腹腔内出血,异位妊娠囊直径<25mm,术后有条件随访,经阴道穿刺不失为一种较好的选择。Objective To investigate the indication, time and prognosis of transvaginal aspiration for the treatment of heterotopic pregnancy（HP）. Methods Between Jan. 2003 and Jun. 2010, Retrospectively analyze the clinical characteristics, duration of hospitalization and pregnancy outcome of the HP patients in the Third Affliated Hospital of Guangzhou Medical College. Results Totally there were 8 HP patients received transvaginal aspiration in the Reproductive Medical Center of the Third Affiliated Hospital of Guangzhou Medical College between January 2003 and June 2010. All patients received transvaginal aspiration. In addiction, two of them received the installation of 2 ml 50% glucose to the ectopic gestational sac. The time of treatment was 43 to 68 days of pregnancy. The diameter of the gestational sac was betweenlSmm and 32mm. The average time of operation was 10. 0 ± 1.8min. The average time of hospitalization was 8.2,5 ± 0. 89 days. One patients suffered from hemorrhage shock due to rupture of the involved tube, 4 hour after the transvaginal aspiration. Sal- pingectomy was performed but the fetal heart stopped 3 days later. Six patients had full-term delivery while one patient had premature delivery at 36 weeks. All the newborn babies were live. The average body weight was 3166. 7 ± 272. 5g. Neither neonatal asphyxia nor birth defects were found. Conclusion Transvaginal aspiration is an option for the confirmed HP patients, if they met the following conditions ： the gestational weeks less than 8, the involved tube not ruptured, no obvious intraperitoneal hemorrhage,the gestational sac smaller than 25ram, have long-term follow-up.

关 键 词：宫内外同时妊娠 经阴道穿刺 

分 类 号：R714.2[医药卫生—妇产科学]