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目的:提高对不典型宫外孕的诊断率,以减少发生破裂出血后给患者造成痛苦和对生命造成威胁。方法:根据3例输卵管妊娠不全破裂致腹膜后血肿的病例,从病史、体征、辅助检查及手术所见进行回顾性分析。结果:3例均为输卵管壶腹部妊娠,致输卵管黏膜及肌层破裂,引起后腹膜血肿。严重的1例血肿延及肝下缘。均以手术及术后病检证实为异位妊娠。结论:输卵管妊娠致输卵管不全破裂,引起后腹膜血肿者临床上极少见且患者的症状及体征表现不典型,误诊率高,故需根据临床表现、体征、血尿妊娠试验、B超等资料综合分析,对高度怀疑者不失时机地进行剖腹探查或腹腔镜检查尤为重要。
Objective: To improve the diagnosis of atypical ectopic pregnancy in order to reduce the occurrence of post-operative bleeding rupture caused pain and life-threatening. Methods: According to the history of 3 cases of tubal pregnancy induced rupture of retroperitoneal hematoma, we retrospectively analyzed the history, signs, auxiliary examinations and surgical findings. Results: 3 cases were tubal ampulla pregnancy, tubal mucosa and myometrial rupture, causing retroperitoneal hematoma. A case of severe hematoma extended to the lower edge of the liver. Surgical and postoperative pathological examination confirmed as ectopic pregnancy. Conclusion: tubal pregnancy caused by rupture of oviducts, causing post-retroperitoneal hematoma were rare in clinical and patients with symptoms and signs of atypical cases, high misdiagnosis rate, so according to clinical manifestations, signs, hematuria, pregnancy test, B- Analysis, it is particularly important for highly skeptical patients to have a laparotomy or laparoscopy without any loss of time.