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腹腔妊娠15例临床特征分析

Analysis of clinical characteristics of 15 patients with abdominal pregnancy

来源期刊: 广州医药 | 67-70 发布时间:2021-11-30 收稿时间:2025/11/13 17:17:13 阅读量:39
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关键词:
腹腔妊娠种植部位治疗
Abdominal pregnancyPlant siteTreatment
DOI:
10.3969/j.issn.1000-8535.2018.06.015
收稿时间:
2018-07-29 
修订日期:
 
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引用总数:
0  
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 of 15 patients who were diagnosed with abdominal pregnancy,which supply reference for clinical work. Methods 15 cases who were diagnosed with abdominal pregnancy and admitted to Guangdong Women and Children hospital between January 2002 and June 2018 were identified. Retrospective analysis was used to summarize the clinical characteristics of diagnosis and treatment in 15 patients. 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 has 8+ weeks pregnant single live fetus by type B ultrasound in other hospital prior to hospitalization.The B ultrasound tests of the other 13 patients 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 for 14 patients.We found more different sites where gestational sacs plant in abdominal pregnancy patients in operation, 5 cases sacs planted in greater omentum, 9 cases sacs planted in pelvic cavity including 1 case sac planted in pelvic wall bottom-right bladder,1 case sac planted in rectum outside right-hand of Douglas pouch,2 cases sacs planted in right utero-sacral ligament,1 case sac planted in right-side of scar in lower uterus segment,1 case sac planted in adhesive tissue between the lift intestinal canal and uterus,1 case sac planted in right pelvic cavity,1 case sac planted in Douglas pouch,1 case sac planted in initiating terminal of the lift round ligament of uterus. The inteventional puncture with medical treatment was supply for only 1 patient,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. Ultrasound is first choice for patient who was considered ectopic pregnancy and better to expansion the inspection range. MRI or CT may find sacs plant site who was considered abdominal pregnancy which may reduce missed diagnosis and misdiagnosis. Surgery is first performed who was diagnosed with abdominal pregnancy. Medical treatment for patients who vital signs are stable.
1、 赵仁峰,许莉莉.原发性腹腔脏器异位妊娠的腹腔镜处理技巧[J]. 中华腔镜外科杂志( 电子版),2017,10(5):304-306. 赵仁峰,许莉莉.原发性腹腔脏器异位妊娠的腹腔镜处理技巧[J]. 中华腔镜外科杂志( 电子版),2017,10(5):304-306.
2、 李玉宏. 早期腹腔妊娠的诊断和治疗[J]. 中国实用妇科与产科杂志,2017,33(9):906-909. 李玉宏. 早期腹腔妊娠的诊断和治疗[J]. 中国实用妇科与产科杂志,2017,33(9):906-909.
3、 邱江南,罗成燕,黄骁昊,等.腹膜后下腔静脉表面异位妊娠1例报告及文献复习[J]. 南京医科大学学报(自然科学版),32016,36(5):629-631. 邱江南,罗成燕,黄骁昊,等.腹膜后下腔静脉表面异位妊娠1例报告及文献复习[J]. 南京医科大学学报(自然科学版),32016,36(5):629-631.
4、 刘彧,荆春丽,李云霞.腹膜后腹主动脉旁异位妊娠1例报告并文献复习[J]. 中国实用妇科与产科杂志,2015,31(7):687-688. 刘彧,荆春丽,李云霞.腹膜后腹主动脉旁异位妊娠1例报告并文献复习[J]. 中国实用妇科与产科杂志,2015,31(7):687-688.
5、 PERSSON J,REYNISSON P,MASBACK A,et al.Histopathology indicates lymphatic spread of a pelvic retroperitoneal ectopic pregnancy removed by robot-assisted laparoscopy with temporary occlusion of the blood supply[J]. Acta Obstet Gynecol Scand,2010,89(6):835-839. PERSSON J,REYNISSON P,MASBACK A,et al.Histopathology indicates lymphatic spread of a pelvic retroperitoneal ectopic pregnancy removed by robot-assisted laparoscopy with temporary occlusion of the blood supply[J]. Acta Obstet Gynecol Scand,2010,89(6):835-839.
6、 DMOWSKI W P,RANA N,DING J,et al.Retroperitoneal subpancreatic ectopic pregnancy following in vitro fertilization in a patient with previous bilateral salpingectomy:how did it get there?[J]. J Assist Reprod Genet,2002,19(2):90-93. DMOWSKI W P,RANA N,DING J,et al.Retroperitoneal subpancreatic ectopic pregnancy following in vitro fertilization in a patient with previous bilateral salpingectomy:how did it get there?[J]. J Assist Reprod Genet,2002,19(2):90-93.
7、 LEE J W,SOHN K M,JUNG H S.Retroperitoneal ectopic pregnancy[J]. AJR,2005,184(5):1600-1601. LEE J W,SOHN K M,JUNG H S.Retroperitoneal ectopic pregnancy[J]. AJR,2005,184(5):1600-1601.
8、 倪美兰. 继发性腹腔妊娠并肠破裂1例[J]. 福建医药杂志,2016,38(2):180-181. 倪美兰. 继发性腹腔妊娠并肠破裂1例[J]. 福建医药杂志,2016,38(2):180-181.
9、 刘维,袁利,文书娟.膈肌妊娠临床诊治1例[J]. 中国现代医学杂志,2017,27(21):128. 刘维,袁利,文书娟.膈肌妊娠临床诊治1例[J]. 中国现代医学杂志,2017,27(21):128.
10、 张晚鱼,付彩文,王雷,等.脾脏妊娠伴脾破裂1例[J]. 临床与实验病理学杂志,2015,31(10),1193-1194. 张晚鱼,付彩文,王雷,等.脾脏妊娠伴脾破裂1例[J]. 临床与实验病理学杂志,2015,31(10),1193-1194.
11、 戴凌. 肝脏妊娠1例报告[J]. 实用医院临床杂志,2017,14(4):254-255. 戴凌. 肝脏妊娠1例报告[J]. 实用医院临床杂志,2017,14(4):254-255.
12、 宣兰萍. 超声在50例特殊部位异位妊娠诊断中的价值[J].中国计划生育学杂志,2017,25(5):340-342. 宣兰萍. 超声在50例特殊部位异位妊娠诊断中的价值[J].中国计划生育学杂志,2017,25(5):340-342.
13、 陆琦,王玉东.2018年美国妇产科医师学会《输卵管妊娠》指南解读[J]. 中国实用妇科与产科杂志,2018,34(3):270-273. 陆琦,王玉东.2018年美国妇产科医师学会《输卵管妊娠》指南解读[J]. 中国实用妇科与产科杂志,2018,34(3):270-273.
14、 RCOG,Diagnosis and management of ectopic pregnancy: green-top guideline No.21[J]. BJOG,2016,123(13):e15-e55. RCOG,Diagnosis and management of ectopic pregnancy: green-top guideline No.21[J]. BJOG,2016,123(13):e15-e55.
15、 STUDDIFORD W.Primary peritoneal pregnancy[Z].Am J Obstet Gynecol,1942,44:487-491. STUDDIFORD W.Primary peritoneal pregnancy[Z].Am J Obstet Gynecol,1942,44:487-491.
16、 BABU A S,ROY J,DAS D,et al.Is surgical intervention for ectopic pregnancy in a low resource set-up avoidable? [J]. J Clin Diagn Res,2014,8(9):OC16-19. BABU A S,ROY J,DAS D,et al.Is surgical intervention for ectopic pregnancy in a low resource set-up avoidable? [J]. J Clin Diagn Res,2014,8(9):OC16-19.
17、 VARMA R,MASCARENHAS L,JAMES D.Successful outcome of advanced abdominal pregnancy with exclusive omental insertion[J].Ultrasound Obstet Gynecol,2003,21(2):192-194. VARMA R,MASCARENHAS L,JAMES D.Successful outcome of advanced abdominal pregnancy with exclusive omental insertion[J].Ultrasound Obstet Gynecol,2003,21(2):192-194.
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