不明位置妊娠的中西医结合诊疗思路  

The diagnosis and treatment scheme of Pregnancy of Unknown Location

作　　者：韩琳[1] 张建伟[2] 

机构地区：[1]山东中医药大学,济南250011 [2]山东中医药大学附属医院中西医结合生殖与遗传中心,济南250011

出　　处：《长春中医药大学学报》2014年第2期272-274,共3页Journal of Changchun University of Chinese Medicine

基　　金：山东省高等学校科技计划项目(J09LF09);山东省研究生教育创新计划项目(SDYC12063)

摘　　要：不明位置妊娠(PUL),由于妊娠位置不同分有宫内妊娠、异位妊娠和生化妊娠,临床结合病史、症状、体征及辅助检查可进一步诊断。当患者有停经史,妊娠试验阳性而阴道超声未见明显的附件包块和宫内孕囊时,应引起重视。根据患者的生育要求,若宫内妊娠可能性大,经验用药,保胎治疗,充分发挥中医治未病的思想;若异位妊娠或生化妊娠可能性大,在患者对PUL风险知情的前提下,杀胚或期待治疗,最大限度保留患者的生育功能,将不明位置妊娠的风险降到最低。无生育要求者,药物杀胚、手术杀胚或期待治疗。Pregnancy of Unknown Location （PUL） includes intrauterine pregnancy, ectopic pregnancy and biochemical preg- nancy due to pregnancy in different positions. Further diagnosis can be made according to medical history, clinical symptoms, signs and auxiliary examination. Attention should be paid to patients with history of menopause, positive result of pregnancy test and no adnexal masses and intrauterine gestational sac by transvaginal ultrasound. According to the patient＇s fertility re- quirements, if intrauterine pregnancy has great possibility, empirical medication and tocolytic therapy should be adopted. The theory of preventive treatment of disease in TCM can be given full play. If the possibility of ectopic pregnancy or biochemical pregnancy is great, in the premise of patients informed of PUL risk, killing embryo or expectant treatment should be adopted.We can try to maximize the reproductive function of patients and minimize the risk of pregnancy of unknown locations. If the patients have no fertility requirements, killing embryos by drugs, operation or expectant treatment should be adopted.

关 键 词：不明位置妊娠 中西医结合疗法 中药 保胎 治未病 杀胚 

分 类 号：R271.9[医药卫生—中西医结合]