妇科腹腔内出血175例临床分析  

Clinical Analysis of 175 Cases of Gynecological Intra-abdominal Hemorrhage

作　　者：郑斐[1] 邵温群[1] 

机构地区：[1]浙江大学医学院附属妇产科医院,浙江杭州310006

出　　处：《实用妇产科杂志》2002年第4期223-224,共2页Journal of Practical Obstetrics and Gynecology

摘　　要：目的 :明确异位妊娠和黄体破裂所致腹腔内出血的临床特征以减少误诊。方法 :对因异位妊娠和黄体破裂所致腹腔内出血急诊入院的 175例患者的临床资料进行回顾性分析。结果 :异位妊娠 134例 ,占 76 .5 7% ,黄体破裂 41例 ,占 2 3.43%。异位妊娠腹腔内出血量为 10 5 1.32± 75 2 .12 ml,2 0 .6 9%患者出血量在 15 0 0 ml以上 ,2 2 .39%有昏厥史 ,停经 (82 .84% )、腹痛 (92 .5 4% )、阴道不规则出血 (76 .12 % )是主要的三联征。黄体破裂腹腔内出血量为 790± 6 39.15 ml,14.6 3%有昏厥史 ,腹痛 (97.5 6 % )是主要症状。内出血量两组比较差异有显著意义 ,P<0 .0 1。本资料 149例经手术止血 ,黄体破裂中 2 6例 (6 3.41% )经保守治疗成功。无一例死亡。结论 :详细询问病史 ,血 HCG检测和阴道 B超检查 。Objectives:To explore the clinical features of intra-abdominal hemorrhage caused by ectopic pregnancy and rupture of corpus luteum for decreasing misdiagnosis.Methods:Medical records and follow-up sheets of 175 emergent hospitalization cases of intra-abdominal hemorrhage caused by ectopic pregnancy and rupture of corpus lutewn were retrospectively analyzed.Results:The rates of ectopic pregnancy and rupture of corpus lutewn were 76.57% and 23.43%,respectively.The volumes of intra-abdominal hemorrhage caused by ectopic pregnancy were 1051.32±752.12 ml.Among them,20.69% of cases were above 1500 ml.The rates of fainted were 22.39%.Amenorrhea(82.84%),stomachache(92.54%) and vaginal anomalo-hemorrhage(76.12%) were capital triad.The volumes of intraabdominal hemorrhage caused by rupture of corpus luteum were 790±639.15 ml. 14.63% cases had pains and stomachache was the main symptom.There was statistically significant difference between the two groups(P<0.01).The 149 cases were surgically treated and the 26 cases of rupture of corpus luteum were conservatively treated.None died.Conclusion:To inquire history detailed and to detect blood HCG level,to have transvaginal ultrasonography examination and to have Cul-De Sac or abdominal paracentesis are convenient and important diagnostic methods.

关 键 词：妇科 异位妊娠 黄体破裂 腹腔内出血 阴道B超检查 腹腔穿刺 病因诊断 阴道后穹窿穿刺 

分 类 号：R711.75[医药卫生—妇产科学] R714.22[医药卫生—临床医学]