11例原发性腹腔妊娠临床分析  

Clinical analysis of 11 patients with primary abdominal pregnancy

作　　者：陈心怡 钱睿亚[1] CHEN Xinyi;QIAN Ruiya(Beijing Obstetrics and Gynecology Hospital,Beijing Maternal and Child Health Care Hospital,Beijing,100026)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院,100026

出　　处：《中国计划生育学杂志》2023年第1期177-181,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨原发性腹腔妊娠的诊断以及病例特点,以降低误诊率及漏诊率。方法:收集2009年2月-2021年5月于本院就诊的11例原发性腹腔妊娠患者临床资料,对其临床特点进行分析。结果:11例术前超声检查仅提示宫腔内未见妊娠囊,宫旁可见非均质包块,均未能明确妊娠部位。术中见5例妊娠物位于直肠子宫陷凹,2例位于子宫骶韧带,2例位于侧盆壁腹膜,1例位于直肠表面,1例位于子宫表面。11例经手术治疗后血β绒毛膜促性腺激素(β-hCG)下降均满意,转归良好。结论:原发性腹腔妊娠发病率低,临床表现不典型,种植部位广泛,易漏诊误诊,术中应做到个体化治疗。Objective:To analyze and summarize the diagnosis and the clinical characteristics of patients with primary abdominal pregnancy,and to reduce the rates of misdiagnosis and missed diagnosis of primary abdominal pregnancy.Methods:The clinical data,such as clinical symptoms,auxiliary examination results,diagnosis,treatment,postoperative pathological results,and prognosis,of 11 patients who had been diagnosed as primary abdominal pregnancy from February 2009 to May 2021 were collected.And the clinical characteristics of these patients were analyzed.Results:11 patients had no gestational sac in the intrauterine cavity and had heterogeneous mass beside their uterus by preoperative ultrasound examination.Both the location of pregnancy and the abdominal pregnancy of the patients had not been identified.During the operation,there were 5 patients with the pregnancy located in their Douglas pouch,2 patients with the pregnancy located in their uterosacral ligament,2 patients with the pregnancy located in their peritoneum of the lateral pelvic wall,1 patients with the pregnancy located on their rectum surface,and 1 patients with the pregnancy located on their uterus surface.The level of serumβ-chorionic gonadotropin(β-HCG)of 11 patients had decreased satisfactorily after operation,and their prognosis were fine.Conclusion:The primary abdominal pregnancy has low incidence,and the clinical manifestations of which are not typical.There are more sites where gestational sacs of the patients can plant,so the primary abdominal pregnancy is easy to miss diagnosis and misdiagnosis.Individualized treatment should be done during operation.

关 键 词：原发性腹腔妊娠 手术治疗 甲氨蝶呤 Β绒毛膜促性腺激素 

分 类 号：R714.22[医药卫生—妇产科学]