休克型异位妊娠30例早期临床表现

Early clinical manifestation of 30 cases of shock ectopic pregnancy

目的探讨休克型异位妊娠的早期预测方法。方法将我院333例出院诊断及病理诊断为异位妊娠的病例按临床特征、手术所见及病理结果分为四组:破裂休克组(23例),流产休克组(7例),破裂组(52例)和流产组(251例)。比较各组间无阴道流血、有下腹痛及腹痛≤1 d三项指标的差异情况。结果本研究中各种类型异位妊娠的构成比依次为流产型75.4%(251/333)、破裂型15.6%(52/333)、破裂休克型6.9%(23/333)、流产休克型2.1%(7/333)。在四组病例中,破裂休克型患者无阴道流血的发生率最高,为65.2%,流产型患者无阴道流血的发生率最低,为11.5%,P<0.05,差异有统计学意义。腹痛症状仍是破裂休克型者中居多,P=0.048,以≤1 d的腹痛为比较项目,则破裂休克型病例中发生最多,为68.2%(15/23),破裂型中发生最少,为33.3%(15/52),差异有统计学意义,P=0.025。结论有停经史、无阴道流血、有近期的短时腹痛(≤1 d)及尿HCG阳性可被看作是破裂休克型异位妊娠的预兆。

Objective To explore early diagnosis method of shock type of eetopic pregnancy. Methods Three hundred and thirty- three ectopic pregnancy cases were divided into four groups- group 1 with rupture shock （23 cases）, group 2 with abortion shock （ 7 cases） , group 3 with rupture （ 52 cases ） , group 4 with abortion （ 251 cases） , and symptoms such as non - vaginal bleeding, lower abdominal pain and the pain within late 1 day were compared. Results The constituent ratio of the four groups were abortion type 75.4% （251/333）, rupture type 15.6% （52/333） , rupture shock type 6. 9% （ 23/333 ） and abortion shock type2. 1% （7/333）in turn. In the four groups, the incidence rate 65. 2% of non - vaginal bleeding was the highest in the rupture shock group（ P 〈 0. 05 ）, and of lower abdominal pain within 1 day was also（ P = 0. 025 ）. Condusion That there are menolipsis, non - vaginal bleeding, lower abdominal pain within 1 day and HCG positive can be thought as a foretoken of shock type of ectopic pregnancy.