子宫部位异位妊娠的处理对策论文.docVIP

　　子宫部位异位妊娠的处理对策论文 【摘要】 目的 探讨子宫部位异位妊娠的临床特点和处理对策。方法 回顾性分析了2000年1月至2006年12月本院收治的子宫部位异位妊娠35例的临床资料，包括一般情况、临床表现、治疗方法等。结果 子宫部位异位妊娠的发病率为2.30%，其中剖宫产切口妊娠发病率为0.33%,宫颈妊娠发病率为0.33%,子宫壁（近峡部）妊娠0.13%,残角子宫妊娠1.51%；35例子宫部位异位妊娠术前仅确诊18例(占51.43)，误诊48.57%，其中阴道大量出血（ 1000ml）5例，腹腔内严重出血（ 1000ml）5例，2例出血 2000ml；剖宫产切口妊娠采用药物加切口妊娠病灶清除术及子宫修补术3例，子宫切除2例；宫颈妊娠药物治疗3例.freelent of ectopic pregnancy in the uterine. Methods 35 patients edical history、clinical manifestation, auxiliary examination, et al. Results The rate of ectopic pregnancy in the uterine isdiagnose，the rate is 48.57%. Ectopic pregnancy in the uterine caused serious bleeding，including heavy colporrhagia（ 1000ml）in 5 cases, intraperitonium bleeding（ 1000ml）in 5 cases, 2 cases of bleeding more than 2000ml;in.cases of ectopic pregnancy in caesarean scar, 3 had medication plus focal cleaning and uterus neoplasty,2 had uterus removel; 3 cases of cervical pregnancy edication, 1 had spontaneous abortion, 1 had scoraping at the cervical canals,.freelbolism on both sides and us uteri had medication and focal cleaning and uterus neoplasty; in cases of pregnancy in rudimentary born, 13 had laparotomy and removal of rudimentary born, 10 had laparoscopic removal of rudimentary born.Conclusion The incidence rate of ectopic pregnancy is increasing in recent years and the the misdiagnosis is easy to make, ay cause serious bleeding or even fertility loss. More attention should be paid to the patients ent 异位妊娠是指受精卵在子宫体腔以外着床（ectopic pregnancy）［1］。随着剖宫产及人工流产刮宫等的增加，受精卵着床在子宫部位的异位妊娠如剖宫产切口部妊娠、子宫壁妊娠、宫颈妊娠及残角子宫妊娠近年渐有报道，子宫部位的异位妊娠如果延误诊治，将产生严重出血甚至永久丧失生育能力。现将2000年1月到2006年12月间本院共收治子宫部位的异位妊娠35例报道如下。 1 资料与方法 1.1 一般资料 本组35例，年龄21～39岁，平均28.60岁。剖宫产切口妊娠、宫颈妊娠各5例，子宫壁（近峡部）妊娠2例、残角子宫妊娠23例。剖宫产切口妊娠5例，剖宫产至发病0.5～5年。术前B超确诊3例。宫颈妊娠及子宫壁（近峡部）妊娠均有多次人流及刮宫史，宫腔操作2～8次。临床表现：均有停经史，停经时间34～120d，平均(51.23±24.12)d。辅助检查：35例尿HCG均阳性，血β-HCG入院时为200.03～54211.51mIU/ml，平均（8850.95±494.13）mIU/ml；18例(51.43%)经超声确诊，其中在峡部或体颈交界处，4例见非均质包块，未见孕囊,包块内见丰富血流。而B超发现子宫外的异常部位有孕囊、胎心、胎体及有薄宫壁子宫，应考虑残角子宫妊娠。 1.2 治疗方法 1.2.1 药物治疗方法