腹腔妊娠15例临床特征分析  

Analysis of clinical characteristics of 15 patients with abdominal pregnancy

作　　者：徐珍[1] 徐丽群 李洁明[1] 周娜[1] 李秀莹[1] 曾俐琴[1] 罗喜平[1] XU Zhen;XU Liqun;LI Jieming;ZHOU Na;LI Xiuying;ZENG Liqin;LUO Xiping(Department of Gynecology Guangdong Women and Children Hospital,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院妇科,广州510010

出　　处：《广州医药》2018年第6期67-70,87,共5页Guangzhou Medical Journal

摘　　要：目的分析15例腹腔妊娠患者的临床病例特点,为临床工作提供参考依据,进一步减少漏诊及误诊的情况。方法收集我院2002年1月—2018年6月期间住院治疗的腹腔妊娠患者的临床病例资料。回顾性分析并总结患者的临床诊治特点。通过t检验,进一步比较腹腔镜与腹式手术患者围手术期情况是否存在统计学差异。结果 1例B超检查提示大网膜妊娠可能;另1例入院前外院B超提示腹腔妊娠,孕8+周单活胎;其余13例患者术前B超提示宫内未见孕囊,子宫旁有包块,提示异位妊娠可能,术前未能明确腹腔妊娠。14例患者行手术治疗,另1例行介入穿刺保守治疗。术中探查发现腹腔妊娠病灶种植部位:位于大网膜5例,位于盆腔9例(膀胱区右下方盆壁1例,子宫直肠窝右侧直肠表面1例,右侧宫骶韧带2例,子宫下段前壁瘢痕处右缘1例,偏左侧肠管与子宫粘连之间1例、右侧盆壁1例、子宫直肠窝1例、子宫左侧圆韧带起始端1例),位于腹腔1例(腰3椎体前方、腹主动脉与下腔静脉之间)。结论腹腔妊娠的异位妊娠病灶种植部位非常广泛,超声检查需进一步扩大检查范围。必要时可选择MRI或CT检查准确定位,减少漏诊及误诊的情况。Objective To analysis and summary clinical characteristics of15patients who were diagnosed with abdominal pregnancy,which supply reference for clinical work.Methods15cases who were diagnosed with abdominal pregnancy and admitted to Guangdong Women and Children hospital between January2002and June2018were identified.Retrospective analysis was used to summarize the clinical characteristics of diagnosis and treatment in15patients.Test statistics used Student's t test to find if there was statistical difference between laparoscopic and abdominal surgery patients in perioperative period.Results One case was likely diagnosed with greater omentum pregnancy by type B ultrasound.Another one patient was diagnosed with abdominal pregnancy which has8+weeks pregnant single live fetus by type B ultrasound in other hospital prior to hospitalization.The B ultrasound tests of the other13patients showed there were no sac in uterus and enclosed mass beside uterus which were diagnosed with ectopic pregnancy,but not positive diagnosis with abdominal pregnancy.Surgery was performed for14patients.We found more different sites where gestational sacs plant in abdominal pregnancy patients in operation,5cases sacs planted in greater omentum,9cases sacs planted in pelvic cavity including1case sac planted in pelvic wall bottom-right bladder,1case sac planted in rectum outside right-hand of Douglas pouch,2cases sacs planted in right utero-sacral ligament,1case sac planted in right-side of scar in lower uterus segment,1case sac planted in adhesive tissue between the lift intestinal canal and uterus,1case sac planted in right pelvic cavity,1case sac planted in Douglas pouch,1case sac planted in initiating terminal of the lift round ligament of uterus.The inteventional puncture with medical treatment was supply for only1patient,CT test showed the sac planted in abdominal:ahead of third lumbar vertebra between abdominal aorta and inferior vena cava.Conclusion There are more sites where gestational sacs can plant in abdominal pregnancy patients.Ul

关 键 词：腹腔妊娠 种植部位 治疗 

分 类 号：R714.223[医药卫生—妇产科学]