特殊部位异位妊娠3例临床分析

Clinical analysis of 3 cases with special site ectopic pregnancy

目的探讨特殊部位异位妊娠的临床诊断和治疗方法。方法对上海市闵行区中心医院收治的3例特殊部位妊娠的患者的临床资料进行回顾性分析并复习相关文献。结果对3例患者行腹腔镜下探查术,术后病理均为绒毛组织,分别诊断为腹膜后妊娠、输卵管间质部妊娠和阔韧带妊娠。结论特殊部位的异位妊娠患者临床症状无特异性,术前诊断较困难。治疗目前仍以手术为主。腹腔镜具有创伤小,视野广,恢复快等优势,是首选的手术方式,但需加强腹腔镜的手术技能,减少输卵管残端妊娠等并发症的发生。术中B超引导下寻找特殊部位病灶值得临床应用。

Objective To investigate the clinical diagnosis and treatment of the special site ectopic pregnancy.Methods Relevant literatures were reviewed and the clinical information from the three patients with special site ectopic pregnancy in Minhang Central Hospital was analyzed.Results After laparoscopic surgeries for the three patients,the postoperative pathology of them was chorion.They were separately diagnosed with a retroperitoneal ectopic pregnancy,an interstitial tubal pregnancy and a broad ligament pregnancy.Conclusion The ectopic pregnancy in specific body areas has no same typical symptom.It is hard to be diagnosed before surgery.The main current treatment is laparoscopic surgery,which has some benefits,such as with small open wounds,broaden horizon,quick recovery.It is the preferred surgical method.But we need improve the laparoscopic surgery skills to reduce the risk of complication,such as the tubal stump fistula.Ultrasound during surgery to find the lesions can be widely used.