异位妊娠84例超声诊断分析  

Ultrasonographic Analysis of 84 Cases with Ectopic Pregnancy

作　　者：李蕊[1] 张燕宏[2] 杜菲[3] 

机构地区：[1]河北医科大学附属石家庄平安医院功能科,石家庄050000 [2]石家庄市第四医院超声科,石家庄050011 [3]衡水市哈励逊国际和平医院超声科,河北衡水053000

出　　处：《临床误诊误治》2015年第6期48-50,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的总结异位妊娠的超声表现,提高超声诊断的正确率。方法回顾分析84例异位妊娠的超声表现,总结其声像图特点。结果本组因停经并腹部疼痛就诊69例(82.1%),因腹部疼痛或隐痛就诊15例(17.9%)。尿h CG阳性79例(94.0%)。超声检查示:51例(60.7%)子宫稍大;80例(95.2%)宫腔内无妊娠囊回声,3例(3.6%)可见假妊娠囊,1例宫内及输卵管同时妊娠者腔内探及妊娠囊;75例(89.3%)在宫腔外探及包块;漏诊5例。本组均经手术及病理检查证实诊断,其中输卵管妊娠79例(47例行输卵管切除术,32例行妊娠组织剥除术),2例宫角妊娠、1例宫颈妊娠(在超声引导下行清宫术),1例腹腔妊娠(行妊娠包块切除术),1例子宫残角妊娠(行子宫残角切除术)。术后均痊愈出院。结论不同类型异位妊娠的声像图各有特点,密切结合病史、临床表现及实验室检查有助于提高术前超声诊断正确率,减少漏诊及误诊。Objective To summarize the ultrasound expression of ectopic pregnancy and improve ultrasound diagno-sis. Methods The ultrasound expressions of 84 patients with ectopic pregnancy were analyzed retrospectively and its features of ultrasonography were summarized. Results 69 cases （82. 1%） visited for menopause and abdominal pain and 15 cases （17. 9%） for abdominal pain or slight pain. hCG of urine in 79 cases （ 94. 0%） was positive. Ultrasonographic results showed：among 84 cases with ectopic pregnancy, uteruses of 51 cases （60. 7%） were slightly large. Gestational sacs were not found in 80 cases （95. 2 %）. ＆quot;False gestational sacs＆quot; were found in 3 cases （3. 6 %）. The gestational sac was found in u-terine cavity of the patient who was pregnant in the uterus and oviduct at the same time. The lumps were found outside uterine cavity in 75 cases （89. 3%）. 5 cases were missed. All the patients of this group underwent surgical treatment and diagnosis was confirmed by pathological examination. Among them were 79 cases of tubal pregnancy （47 patients underwent resection of the fallopian tube, 32 routine pregnancy tissue removal） , 2 cases of palace angle of pregnancy, 1 case of cervical pregnancy （ in ultrasound guided downward qing dynasty palace） , 1 case of abdominal pregnancy （ pregnancy mass resection） , 1 case of uterus residual angular pregnancy （ uterus residual angular resection） . All the patients recovered. Conclusion There are dif-ferent ultrasonographic characteristics in different types of ectopic pregnancy. It is helpful to improve the diagnostic accuracy rate, to reduce the missed diagnosis and misdiagnosis rates with analysis of the case history, clinical manifestations and labora-tory examination results.

关 键 词：妊娠 异位 超声检查 误诊 

分 类 号：R714.22[医药卫生—妇产科学]