61例卵巢妊娠的临床诊治分析

A clinical analysis of 61 cases of ovarian pregnancy

目的探讨卵巢妊娠的病因及临床诊治特点。方法回顾性分析1993年7月至2009年12月本院收治的61例卵巢妊娠病例。结果1993年7月-2009年12月来本院诊治异位妊娠3750例，其中卵巢妊娠61例，占同期异位妊娠1．63％，以右侧卵巢发生居多（65．57％），平均孕龄43．68天。其中58例（95．08％）腹痛，21例（34．43％）阴道出血，46例（75．41％）停经。多数有异位妊娠高危因素：42例（68．85％）有妇科疾病史，40例（65．57％）有人工流产史，22例（36．07％）放置宫内节育器。无1例患者术前确诊，均手术治疗，其中6例行腹腔镜手术。结论妇科疾病、人工流产及放置宫内节育器与卵巢妊娠发病关系密切。应结合血B一人绒毛膜促性腺激素及阴道B超以提高术前诊断率。

Objective To determine etiology and clinical characteristics of ovarian pregnancy（OP）. Methods The clinical data of women with OP admitted to and treated in Buji People＇ s Hospital of Longgang District of Shenzhen City in a period from July, 1993 to December, 2009 were retrospectively analyzed. Results 61 patients（ 1.63% ） with OP among a cohort of 3750 ectopic pregnancy （EP） were diagnozed and treated in the 16-year period. OP occurred on the right side more commonly. The mean gestational age of the pregnant women was 43.68 days. Of which, 58 patients（95.08% ） had abdominal pain, 46 （75.41%） presented amenorrhea and 21 （ 34.43% ） had vaginal bleeding. Most patients had high risk factors of EP, among which 42 patients （68.85%） had gynecologic diseases,40 patients （65.57%） had history of induced abortion and 22 patients （36.07%） had currently used intrauterine device （IUD）. No one had been diagnosed before operation. All patients received surgery, including 7 cases of laparoscopic operation. Conclusion OP is closely related to gynecologic diseases, induced abortion and IUD placement. Preoperative diagnosis is often difficult due to no specific clinical presentations. Detection of β-hCG combined with transvaginal ultrasonography could improve preoperative diagnostic accuracy.