异位妊娠18例误诊临床分析

Clinical analysis of misdiagnosis of ectopic pregnancy in 18 cases

目的探讨异位妊娠的正确诊断及鉴别诊断。方法回顾性分析1996年7月至2006年7月我院收治的将异位妊娠误诊为其它疾病4例及将其它疾病误诊为异位妊娠14例的临床资料。结果异位妊娠误诊为其它疾病4例,均误诊为宫内孕:其它疾病误诊为异位妊娠14例中宫内孕2例,卵巢破裂3例,慢性盆腔炎1例,出血性输卵管炎2例,脾破裂1例,葡萄胎1例,绒癌1例,子宫内膜异位症2例,宫腔粘连综合征1例。结论异位妊娠的正确诊断应该结合病史,β-HCG监测,影像学检查,刮宫等综合考虑,对难以诊断的患者,可以通过开腹或腹腔镜手术明确诊断。

Objective To explore the diagnosis and differential diagnosis of ectopic pregnancy, Methods From July 1996 to July 2006, the clinical pathologic materials of 4 eases with ectopie pregnancy which were misdiagnoged as other disease and 14 eases without ectopic pregnancy which were misdiagnosed as ectopic pregnancy were analyzed retrospectively. Results The 4 cases with eetopie pregnancy were misdiagnosed as eutopic pregnancy; Of the 14 eases of other diseases overdiagnosed as ectopie pregnancy, 2eases with eutopiepregnancy, 3 eases with ruptured ovary, 1 case with pelvieitis, 2 cases with hemorrhagic salpingitis, 1 case with ruptttred spleen, 1 case with hydatidiform mole, 1 case with ehoriocarcinoma, 2 cases with endometriosis, 1 case with uterine cavity adhere syndrome were misdiagnosed Conclusions The diagnosis and the differential diagnosis of ectopie pregnancy should be made in accordance with considering all diagnostic procedures, such as clinical history and examination, measure of serum HCG level, eolottr uttrosound, digital subraetion angiography, and diagnostic curettage, so as to avoid the misdiagnosis and over-diagnosis. In ease of elusive patients, the recommended reliable management is laparotomy or laparoseopy.