卵巢妊娠与输卵管妊娠的临床比较分析

Comparative analysis of ovarian pregnancy with tubal pregnancy

目的探讨卵巢妊娠的病因、临床表现及诊治特点。方法对北京市海淀区妇幼保健院2002年1月至2011年12月诊治的26例卵巢妊娠病例进行回顾性分析，并与同期52例输卵管妊娠进行对照分析研究。结果①卵巢妊娠发病率占同期异位妊娠的0．52％，无逐年增加的趋势（χ2=2．398，P：0．663〉0．05）；输卵管妊娠占86．45％，发病率逐年下降（χ2=97．940，P=0．000〈0．01）；②卵巢妊娠与输卵管妊娠临床表现相似，术前确诊困难，误诊率高达96．15％。卵巢妊娠停经史占76．92％，停经时间短，平均38．65±10．57天，与输卵管妊娠（45．37±7．81天）比较，差异有显著性（t=-3．171，P=0．002〈0．01）；两组腹痛发生率、阴道出血发生率及休克发生率差异均有显著性（χ2值分别为5．880、10．054、8．432，均P〈0．05）。结论卵巢妊娠仍以手术治疗为主，输卵管妊娠逐渐趋向药物治疗，腹腔镜手术治疗异位妊娠呈上升趋势。

Objective To explore the etiology, clinical manifestations, diagnosis and treatment of ovarian pregnancy. Methods From January 2002 to December 2011, 26 cases of ovarian pregnancy were diagnosed and treated in Maternal and Child Health Hospital of Haidian District. The data of them were retrospectively analyzed and compared with that of 52 cases of tubal pregnancy at the same period. Results Ovarian pregnancy occupied 0.52% of ectopic pregnancy of the same period, and there was not increasing trend year＇by year （χ2 = 2.398 ,P = 0. 663 〉 0. 05 ）. Tubal pregnancy occupied 86.45%, and the incidence rate decreased year by year （χ2 = 97.94, P = 0.000 〈 0. 01 ）. Because of similar clinical manifestations, preoperative diagnosis of ovarian pregnancy and tubal pregnancy was difficult, and the misdiagnosis rate was 96.15%. Ovarian pregnancy with menopause accounted for 76.92%, and the menopausal period was short, with average time of 38.65 ± 10.57 days. It was significantly different when compared with that of tubal pregnancy （45.37 ±7.81 days） （ t = - 3.171,P = 0. 002 〈 0. 01 ）. There were significant differences in the incidence rates of abdominal pain, vaginal bleeding and shock between two groups. Conclusion Ovarian pregnancy is mainly treated with surgery, while the treatment of tubal pregnancy gradually turns to drug therapy. Laparoscopic surgical treatment of ectopic pregnancy shows an upward trend. [ Key words ]