卵巢妊娠43例临床分析

Clinical analysis of 43 cases of ovariocyesis

目的：探讨卵巢妊娠的病因、临床特征及诊治特点。方法：回顾性分析1993年7月～2005年12月我院收治的43例卵巢妊娠病例。结果：卵巢妊娠占同期异位妊娠1．81％，绝大多数卵巢妊娠患者（97．67％）社会经济地位低下，有人流（65．12％）及妇科病史（60．47％），37．21％放置宫内节育器。卵巢妊娠最主要症状是腹痛（93．02％），仅74．42％有停经史，37．21％阴道出血。所有患者无1例术前确诊，均手术治疗，其中5例行腹腔镜手术。结论：卵巢妊娠发生率呈上升趋势，与人流、妇科疾病及放置宫内节育器有关。开展以社区为基础的综合健康教育来提高妇女健康意识十分迫切。因临床表现不典型，术前很难确诊，应充分结合血β-HCG及阴道B超以提高术前诊断率。治疗应以手术为主。腹腔镜手术安全、有效，值得推广。

Objective： To explore the etiological factors, clinical features and diagnosis and treatment of ovariocyesis. Methods： 43 cases of ovariocyesis in this hospital from July 1993 to December 2005 were retrospectively analyzed. Results： The cases of ovariocyesis accounted for 1.81% in ectopic pregnancies. The 97.67% of ovariocyesis had lower cases of ovariocyesis, 65. 12% had induced abortion, 60.47% had gynecological history, 37. 21% had intrauterine contraceptive devices. 93.02% had abdominal pain, 74. 42% menelipsis history, 37.21% vaginal bleeding. All patients had no preoperative diagnosis, all accepted surgery. 5 cases accepted laparoscopic operation. Conclusion： The incidence of ovariocyesis presents ascending trend, is related to induced abortion, gynecological disease and intrauterine contraceptive devices. Comprehensive health education based on community is urgently developed to enhance the womeng health awareness. Ovariocyesis is not easy to be diagnosed before operation for atypical clinical manifestation. Combining blood β- HCG and vagina B ultrasound could enhance preoperational diagnostic rate. The treatment of ovariocyesis is mainly surgery. Laparoscopic surgery is safe, effective and worth of generalization.