82例异位妊娠误诊的临床分析

Clinical Analysis of 82 Cases Misdiagnosis of Ectopic Pregnancy

目的探讨异位妊娠误诊原因,提高异位妊娠的诊治水平。方法回顾性分析2005年1月至2010年1月误诊的异位妊娠患者82例。结果妇产科误诊56例,其他科室误诊26例。将异位妊娠误诊为其他妇科疾病,主要是:宫内孕或/和先兆流产、月经失调、盆腔炎、黄体破裂、滋养细胞肿瘤、盆腔包块待查等,误诊为内、外科的疾病急性胃肠炎、肠梗阻、阑尾炎、感染性休克等。结论异位妊娠临床症状表现不典型时,临床医生对病史、体征的采集不全,专业知识欠缺,辅助检查的误导,是异位妊娠误诊的主要原因。

Objective To explore the factor of ectopic pregnancy misdiagnosis, improve the diagnosis and treatment of ectopic pregnancy. Methods Misdiagnosed 82 patients with ectopic pregnancy from January 2005 to January 2010 were retrospective analyzed. Results 56 cases of misdiagnosis were in gynecology and obstetrics department, 26 cases of misdiagnosis were in other departments. The ectopic pregnancy misdiagnosed as other gynecological diseases, mainly： intrauterine pregnancy and/or threatened abortion, menstrual disorders, pelvic, corpus luteum rupture, trophoblastic tumor and other pelvic masses of unknown origin; misdiagnosed as internal disease and surgical disease： acute gastroenteritis, obstruction, appendicitis, infection shock. Conclusion Clinical symptoms of ectopic pregnancy is not typical, incomplete collection of history and signs, lack of expertise, misleading of laboratory examination is the main reason for misdiagnosis of ectopic pregnancy.