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目的探讨宫内外复合妊娠临床特点及腹腔镜治疗术后妊娠结局。方法回顾性分析2007年7月至2014年6月就诊于四川大学华西第二医院且诊断为宫内外复合妊娠患者共30例,分析其临床特点并随访腹腔镜治疗后妊娠结局。结果30例患者中,停经后下腹痛11例(36.67%);腹痛伴不规则阴道流血9例(30.00%);阴道不规则流血或咖啡色分泌物2例(6.67%);无临床症状,仅通过B超发现8例(26.67%);体外授精-胚胎移植(IVF-ET)患者(22例)中移植后14d血β-人体绒毛膜促性腺激素(β-HCG)水平大于300mIU/mL 17例(77.27%)。腹腔镜手术取出宫外妊娠的胚胎组织后继续宫内妊娠26例,后宫内胚胎停育4例(4/26,15.38%),足月产22例(22/26,84.62%)。结论停经后腹痛、阴道流血、IVF-ET术后14d血β-HCG高于300mIU/mL时需警惕宫内外复合妊娠,腹腔镜手术对宫内外复合妊娠具有良好的治疗效果,80%以上的患者均可以获得良好的妊娠结局,值得推广。
Objective To investigate the clinical features of intrauterine and extracapsular pregnancy and the outcome of postoperative pregnancy by laparoscopy. Methods A retrospective analysis of 30 patients who were diagnosed as intrauterine and extracapsular pregnancy in the Second West China Hospital of Sichuan University from July 2007 to June 2014 was performed. The clinical features were analyzed and the pregnancy outcomes were followed up. Results Among the 30 patients, 11 cases (36.67%) had abdominal pain after menopause; 9 cases (30.00%) had abdominal pain with irregular vaginal bleeding; 2 cases (6.67%) had vaginal irregular bleeding or brownish excretion; 8 cases (26.67%) were found by B ultrasound; the level of serum β-human chorionic gonadotropin (β-HCG) was greater than 300mIU / mL at 14 days after transplantation in 22 patients with IVF-ET Example (77.27%). Twenty-six intrauterine pregnancies were continued after laparoscopic removal of ectopic pregnancy and four (14/26, 15.38%) were intrauterine embryos. There were 22 full-term births (22/26, 84.62%). Conclusions Postmenopausal abdominal pain, vaginal bleeding, 14 d after IVF-ET blood β-HCG higher than 300mIU / mL need to be wary of intrauterine and extracapsular pregnancy, laparoscopic surgery has a good therapeutic effect on intrauterine and extracapsular pregnancy, more than 80% of patients Can get a good pregnancy outcome, it is worth promoting.