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目的:分析腹腔妊娠的临床特点,进一步探讨腹腔妊娠的早期诊断、早期治疗方法。方法:回顾性分析2005～2010年收治的9例腹腔妊娠患者临床资料。结果:该院近5年腹腔妊娠占同期异位妊娠的0.38%(9/2376),其中原发性腹腔妊娠2例,继发性腹腔妊娠7例;腹腔妊娠者平均年龄为28.2岁,其发生原因与盆腔或宫腔炎症有一定的关系,术前误诊率为100.0%,诊断率极低;临床表现同输卵管妊娠,以停经及腹痛为主要临床表现。9例均接受手术治疗,术中发现妊娠部位在子宫直肠窝占44%(4/9),术中盆腔积血7例,为50～600 ml(平均293.75 ml,3例出血>500 ml)。术后随访1例因术后血HCG下降不满意,加服米非司酮治疗3天后,血HCG下降满意,至术后36天降至正常。结论:腹腔妊娠发病率低,临床表现无特异性,术前误诊率极高,对于高度怀疑异位妊娠的病例,早期行腹腔镜检查可提高腹腔妊娠的早期诊断率,确诊后尽快手术是唯一有效的治疗方法。
Objective: To analyze the clinical features of abdominal pregnancy and to further explore the early diagnosis and early treatment of abdominal pregnancy. Methods: The clinical data of 9 patients with celiac pregnancy admitted from 2005 to 2010 were retrospectively analyzed. Results: Intrauterine pregnancy in the past 5 years accounted for 0.38% (9/2376) of the ectopic pregnancy in the same period, including 2 cases of primary intraperitoneal pregnancy and 7 cases of secondary abdominal pregnancy. The average age of intraperitoneal pregnancy was 28.2 years Occurrence of pelvic or uterine inflammation and have a certain relationship, preoperative misdiagnosis rate was 100.0%, the diagnostic rate is very low; clinical manifestations with tubal pregnancy, with menopause and abdominal pain as the main clinical manifestations. 9 cases were treated by surgery, intraoperative findings in the uterine rectum, 44% (4/9), intraoperative pelvic hemorrhage in 7 cases, 50 ~ 600 ml (average 293.75 ml, 3 bleeding> 500 ml) . Patients were followed up 1 patient after blood HCG drops are not satisfied, plus 3 days after mifepristone treatment, serum HCG drops satisfaction, to 36 days after surgery to normal. Conclusions: The incidence of abdominal pregnancy is low, the clinical manifestations are non-specific and the preoperative misdiagnosis rate is very high. For cases with high suspicion of ectopic pregnancy, early laparoscopy can improve the early diagnosis rate of abdominal pregnancy, and the surgery as soon as possible after diagnosis is the only Effective treatment.