宫内宫外同时妊娠1例报告

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1 病历摘要患者,36岁,住院号139608。因停经45天,伴乏力,恶心呕吐,于1997年9月20日入我院行人工流产术,术后检查刮出物,基本符合妊娠天数,遂嘱其带药回家休息治疗。术后第3天,患者仍觉早孕反应未消失,并伴下腹坠痛及少量阴道流血,自疑“不全流产”来院复诊。查体:T36.9℃,P92次/min,R19次/min,BP15/10kPa,面色苍白,神情倦怠,痛苦貌,心肺听诊无异常,腹软,有压痛及反跳痛,无肌紧张,肝脾未触及,移动性浊音阳性。妇科检查:阴道内有少量暗红色血液,宫颈举痛,后穹窿饱满,触痛明显,子宫平位略大、软,右侧附件区触及一边缘不清之包块,压痛明显。辅助检查:B超示:右附件实质性包块,盆腹腔积液,尿 FT(+),血Hb 90g/L,WBC9.8 1 patient summary patient, 36 years old, hospital number 139608. Due to menopause 45 days, with fatigue, nausea and vomiting, September 20, 1997 into our hospital artificial abortion, check the scraped postoperatively, basically in line with the number of gestational days, and then told them to go home with medication rest. On the third day after operation, the patient still felt that the reaction of early pregnancy did not disappear, accompanied by abdominal pain and a small amount of vaginal bleeding, suspect “incomplete abortion” to hospital for referral. Examination: T36.9 ℃, P92 times / min, R19 times / min, BP15 / 10kPa, pale, look tired, pain appearance, cardiopulmonary auscultation no abnormalities, abdominal softness, tenderness and rebound tenderness, no muscle tension, Liver and spleen not touched, mobility dullness positive. Gynecological examination: a small amount of dark red blood within the vagina, cervical pain, after the dome was full, tenderness significantly, uterine level slightly larger, soft, right attachment area touches an unclear mass, tenderness significantly. Auxiliary examination: B ultrasound showed: the right attachment substantive mass, pelvic ascites, urine FT (+), blood Hb 90g / L, WBC9.8
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