特殊部位异位妊娠25例临床分析  

Clinical analysis of 25 cases of special-site ectopic pregnancy

作　　者：张静[1] 蒋洁[1] 刘晓英[1] 杜善平[1] 

机构地区：[1]陕西省人民医院,陕西西安710068

出　　处：《中国妇幼健康研究》2017年第12期1757-1759,共3页Chinese Journal of Woman and Child Health Research

基　　金：陕西省社会发展科技公关资助项目(项目编号S2016YFSF0621)

摘　　要：目的探讨特殊部位异位妊娠临床特征、误诊原因及治疗情况。方法回顾性分析陕西省人民医院2014年12月至2016年12月25例特殊部位异位妊娠临床资料。结果特殊部位异位妊娠发生率占同期异位妊娠的11.63%,其中瘢痕妊娠5例(2.33%)、卵巢妊娠6例(2.79%)、宫角妊娠9例(4.19%)、残角子宫妊娠2例(0.93%)、子宫肌壁间妊娠1例(0.47%)、异位输卵管妊娠妊娠2例(0.93%),术前定位诊断率为28.00%,误诊率为72.00%,较同期输卵管妊娠术前定位诊断准确率明显偏低(χ~2=75.285,P=0.000)。结论特殊部位的异位妊娠发病率低,症状不典型,极易误诊,详询病史,全面查体,配合相应的辅助检查,客观综合地分析病情,是诊断的关键,对于高度怀疑者尽早行剖腹探查或腹腔镜探查术。采取合理的避孕措施可以预防异位妊娠发生。Objective To explore the clinical characteristics,reasons for misdiagnosis and treatment of special-site ectopic pregnancy.MethodsThe retrospective analysis was performed on 25 cases of special-site ectopic pregnancy in Shaanxi Province People＇s Hospital from December 2014 to December 2016.Results The incidence of special-site ectopic pregnancy was 11.63% of ectopic pregnancy in the same period.Among them,there were 5 cases（2.33%）of scar pregnancy,6 cases（2.79%）of ovarian pregnancy,9 cases（4.19%）of uterine corneal pregnancy,2 cases（0.93%）of pregnancy in rudimentary uterine horn,1 case（0.47%）of intramural pregnancy,and 2 cases（0.93%）of ectopic fallopian tube ectopic pregnancy.The preoperative location diagnosis rate was 28.00%,and the misdiagnosis rate was 72.00%.The preoperative location diagnosis rate of special-site ectopic pregnancy was significantly lower than that of the tubal pregnancy（χ~2=75.285,P=0.000）.Conclusion The incidence of specialsite ectopic pregnancy is low and the clinical features are not typical,so it is easy to misdiagnose.Detailed consultation with medical history,comprehensive physical examination,corresponding auxiliary examination,objective and comprehensive analysis of the condition are keys to diagnose the disease.For cases of highly suspicion,laparotomy or laparoscopic exploration should be performed as early as possible.Reasonable contraception can prevent ectopic pregnancy.

关 键 词：异位妊娠 特殊部位 临床特征 误诊 

分 类 号：R714.22[医药卫生—妇产科学]