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目的:探讨误诊为异位妊娠的早期宫内孕患者的临床特征和鉴别诊断方法,提高鉴别诊断水平,避免过度治疗。方法:早期宫内孕误诊为异位妊娠患者26例,对其临床资料进行回顾性分析。结果:患者平均年龄27.2岁。26例全部有停经史,22例有下腹痛,20例有阴道出血。合并卵巢黄体破裂出血19例,合并附件囊性包块15例。B超、血β-hCG动态监测15例,行腹腔镜探查术14例,诊刮术12例。结论:早期异常宫内妊娠合并附件囊性包块、早早孕并卵巢黄体破裂内出血、B超探及孕囊时间滞后是该病的主要临床特征和误诊原因。在情况允许的条件下,B超、血β-hCG联合动态监测甚为重要。误诊可能导致过度治疗。
Objective: To investigate the clinical characteristics and differential diagnosis of early intrauterine pregnancy misdiagnosed as ectopic pregnancy, to improve the differential diagnosis and avoid over-treatment. Methods: Early intrauterine pregnancy misdiagnosed as ectopic pregnancy in 26 patients, the clinical data were retrospectively analyzed. Results: The average age of patients was 27.2 years. All 26 had history of menopause, 22 had lower abdominal pain, and 20 had vaginal bleeding. 19 cases of ovarian lupus rupture hemorrhage, annex annex cystic mass in 15 cases. B ultrasound, blood β-hCG dynamic monitoring in 15 cases, laparoscopic exploration in 14 cases, curettage in 12 cases. Conclusion: The early abnormal intrauterine pregnancy complicated with cystic mass, early pregnancy and rupture of ovarian corpus luteum, B ultrasonography and gestational sac lag time are the main clinical characteristics and misdiagnosis reasons. Under conditions permitting, B ultrasound, blood β-hCG joint dynamic monitoring is very important. Misdiagnosis may lead to over-treatment.