【摘要】 目的探讨异位妊娠的临床特点、人群分布及有效的诊断方法。方法回顾性分析我院1992年1月至2003年1月收治的272例异位妊娠病例资料。结果发病率最高年龄段20~30岁,共142例(52.2%);发生腹痛264例(97%),有停经史176例(64.8%),阴道流血179例(65.7%),盆腔包块200(73%)。检测血HCG 83例(30.51%),54例(3.1 ng/m l(65%),尿HCG 90例(33.08%),34例阳性(38%)。后穹隆穿刺128例(47.05%),见不凝血120例(93%)。B超检查245例(90.07%),238例诊断与术中结果相符,诊断符合率97%。绝经2年后发病1例(0.36%),未婚12例(4.4%),重复异位妊娠15例(5.7%)已行绝育术38例(13.97%)。放节育环避孕90例(33.08%)。结论异位妊娠的发病高峰年龄较10年前提前了10年;临床症状中,腹痛发生率最高,停经与阴道流血发生率相似,腹痛的程度和性质与妊娠破裂部位有关;出血量除与妊娠破裂部位有关外,还与破裂或流产至就诊时间的长短有关;陈旧性异位妊娠多有以软、边界不清、触痛、拒按为特点的盆腔包块;阴道后穹窿穿刺、彩色B超诊断阳性率高于其他检测手段。血HCG定量检测优于尿HCG的定性检测,但仅适用于活的或近期破裂胚胎组织;未婚、女扎、放环、有异位妊娠史者及近期绝经者仍是异位妊娠不可忽视的发病群体;认真的询问病史,及时行有效的辅助检查是降低误诊的有效方法。更多还原

【Abstract】 Objectire To investigate the clinical characteristic of unusual gravidity and crowd distributing and the diagnostic method.Methods: The retrospective analysis to the datum for the 272 unusual gravidity cases the eleven years from January in 1992 to the January in 2003.Results: The maximal ages of the incidence of a disease centralizes about 20-30 years old,142 cases (52.2%) in all.Among them there are 264 cases(97%) for bellyache,176 cases(64.8%) for emmeniopathy,179 cases(65.7%) for vagina blood,and 200 cases(73%) for tubbing bump.Exsanguinations testing HCG has about 83 cases(30.51%),54 cases >3.1ng/ml(65%),and emiction HCG about 90 cases(33.08%),masculine for 34 cases(38%).The centesis for back cove about 128 cases(47.05%),non-cruor about 120 cases(93%).B ultrasonic for 245 cases(90.07%),and the diagnosis for 238 cases match case with operation.So the accord rate is about 97%.Only 1 case (0.36%) is taken bad two years after menopause,12 cases(4.4%) for the spinsterhood,15 cases(5.7%) for repeating unusual gravidity,38 cases(13.97%) for sterilization,90 cases(33.08%) for birth control ring.Conclusions The fastigium age has advanced about ten years comparing with the ten years befor,and in the clinic symptom,the bellyache rate is the highest;the genesic rate for menopause is similar to vagina blood,the degree and the characteristic of bellyache is related to the gestation rent;The blood amount relates both the gestation rent and the length from the fracture or abortion to cure;dated unusual gravidity is the tubbing bump for the characteristic of soft,faint boundary and ache et al;The electropositive rate for back cove centesis in vagina and colorful B ultrasonic diagnoses is higher than other testing method.The HCG of blood quantitative testing is better than the testing in HCG of urine only the same with the alive or the embryonic organization;the people of discoverture,birth control for the woman,ring wearing,unusual gravidity and menopause lately are the keystone colony;the efficient method to reducing the wrong diagnoses is serious inquiring about the state of illness and the timely assistant testing.更多还原