[1]邵建兰*,张苗,甘艳琼.117例输卵管间质部妊娠诊治分析[J].中国计划生育和妇产科,2017,(10):51-54.
　SHAO Jian-lan*,ZHANG Miao,GAN Yan-qiong.Analysis of diagnosis and treatment of 117 cases of interstitialtubal pregnancy[J].Chinese Journal of Family Planning & Gynecotokology,2017,(10):51-54.
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117例输卵管间质部妊娠诊治分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年10期
页码:
51-54
栏目:
论著与临床
出版日期:
2017-10-25

文章信息/Info

Title:
Analysis of diagnosis and treatment of 117 cases of interstitial tubal pregnancy
作者:
邵建兰*; 张苗; 甘艳琼
川北医学院附属医院妇产科
Author(s):
SHAO Jian-lan*; ZHANG Miao; GAN Yan-qiong
Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan, 637000, P.R.China
关键词:
输卵管间质部妊娠; 诊断; 治疗
Keywords:
interstitial tubal pregnancy;  diagnosis;  treatment
分类号:
R 714.22
摘要:
目的探讨输卵管间质部妊娠(interstitial tubal pregnancy，ITP)的诊治方法。方法对川北医学院附属医院2006年7月至2016年6月收治的117例ITP病例的临床资料进行回顾性分析。结果① 诊断：保守治疗组13例全部经阴道三维B超诊断。手术治疗组104例，术前B超拟诊异位妊娠83例，其中确诊ITP 61例，准确率735 %（61/83）；21例因腹腔内出血急诊术中探查确诊，占202 %（21/104）。② 治疗：腹腔镜手术较开腹手术时间短、出血少、术后活动时间早，差异有统计学意义（P<005）；保守治疗组选用氟尿嘧啶(fluorouracil,5-FU)与甲氨蝶呤(Methotrexate,MTX)化疗，血清β-人绒毛膜促性腺激素(β-human choionic gonadotophin, β-hCG)降至正常时间较手术组长，差异有统计学意义（P<005）。结论 ① 对ITP需做到“三早”，即早就诊、早诊断、早治疗。为明确妊娠部位，阴道三维B超可作为首选检查方法；② 手术仍是ITP的主要治疗方法，腹腔镜较开腹手术具有时间短、出血少、术后恢复快等优势；③ 对于血β-hCG浓度低、无内出血、病灶小的早期间质部妊娠或稽留流产型患者选用5-Fu与MTX保守治疗可取得满意疗效。
Abstract:
ObjectiveTo investigate the methods of diagnosis and treatment for interstitial tubal pregnancy(ITP). MethodsThe clinical data of 117 cases of ITP were analyzed retrospectively from July 2006 to June 2016 in Affiliated Hospital of North Sichuan Medical College. Results① Diagnosis: 13 cases of the conservative treatment group were diagnosed by transvaginal ultrasonography. For the 104 cases of surgical treatment group, 83 cases were diagnosed of ectopic pregnancy by B-scan ultrasonography before operation, of which 61 cases were confirmed with ITP, the accuracy rate was 735 % (61/83); 21 cases were confirmed the diagnosis due to intraoperative hemorrhage within the emergency surgery,accounting for 202 % (21/104). ② Treatment: Laparoscopic surgery was shorter than laparotomy, with less bleeding and earlier postoperative activity, the differences were statistically significant(P<005). Time for the levels of serum β-hCG to reduce to normal in conservative treatment group, who were treated with 5 - Fu and MTX as chemotherapy,was longer than the surgical group, the differences were statistically significant (P<005). Conclusion① ITP should be treated with“three earlys”, that is, early medical advice, early diagnosis and early treatment. To determine the location of pregnancy, vaginal three-dimensional ultrasonography can be used as the preferred method of inspection; ② Surgery is still the main treatment for ITP,while laparoscopic surgery has advantages of shorter time, less bleeding, earlier postoperative recovery and so on;③ For patients with low blood β-hCG concentration, no internal bleeding, small lesions of early interstitial pregnancy or missed abortion patients, 5-Fu and MTX conservative treatment can achieve satisfactory results.

参考文献/References:

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更新日期/Last Update: 2017-10-25