Clinical Analysis of Ectopic Pregnancy in the Uterine_West China Medical Journal

Authors：

WAN Hong ¹ , XIONG Wei ²

1. Department of Gynecology and Obstetrics, Sichuan Provincial Hospital of Women and Children, Chengdu, Sichuan 610031, P.R.China; 2. Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China;

Corresponding author：

Keywords：

子宫部位异位妊娠; 子宫切口妊娠; 子宫峡部妊娠; 宫颈妊娠; 氨甲喋呤

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【摘要】目的 探讨子宫部位异位妊娠的临床特征和处理对策。方法回顾分析2002年9月-2009年9月间收治的31例子宫部位异位妊娠患者的临床资料。结果 31例患者中，初诊确诊仅8例，误诊率74.2%。除5例因难以控制的大出血行经腹病灶清除术加子宫修补术或全子宫切除术外，其余26例患者均经氨甲喋呤（MTX）治疗加清宫术或宫腔镜下病灶清除术保守治疗成功。结论子宫部位异位妊娠容易误诊，超声检查是诊断的主要方法。保守治疗安全、有效，可保留生育能力。氨甲喋呤治疗加清宫术可作为治疗子宫部位异位妊娠的主要方法。
【Abstract】 Objective To investigate the clinical characteristics and treatment of ectopic pregnancy in the uterus. Methods The clinical data of 31 patients diagnosed as ectopic pregnancy from September 2002 to September 2009 were analyzed retrospectively. Results During preliminary diagnosis, only eight patients were accurately diagnosed.The error rate of first diagnosis was 74.2%. Five patients suffered focal cleaning and uterus neoplasty or total hysterectomy due to uncontrollable bleeding.The other 26 patients were successfully cured by conservation treatment of methotrexate (MTX) combined with dilatation and curettage or clearance of focal lesion under hysteroscopy. Conclusion Misdiagnosis of ectopic pregnancy in the uterus is easy to make.The ultrasonography is the main method for the diagnosis of ectopic pregnancy in the uterus.Conservative treatment is proved to be safe and effective and can preserve the patients’ fertility. Administration of MTX combined with dilatation and curettage is an main therapeutic method in handling ectopic pregnancy in the uterus.

Citation： WAN Hong,XIONG Wei. Clinical Analysis of Ectopic Pregnancy in the Uterine. West China Medical Journal, 2010, 25(8): 1462-1464. doi: Copy

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4.	罗红, 杨太珠, 郭文琪, 等. 子宫峡部妊娠的超声诊断价值[J]. 中国医学影像技术, 2005, 21(2): 324-325.
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11.	丁霞, 石钢, 杨太珠, 等. 剖宫产后切口妊娠的临床诊治分析[J]. 实用妇产科杂志, 2006, 22(5): 306-308.
12.	刘菊红, 李坚. 10年子宫腔下部妊娠病例的回顾性分析[J]. 首都医科大学学报, 2006, 27(1): 113-116.
13.	邓新粮, 何小丽, 肖松舒. 剖宫产后子宫切口部位妊娠保守治疗16例疗效分析[J]. 实用妇产科杂志, 2008, 24(6): 372-373.
14.	代新学, 游海燕, 周丹. 子宫动脉栓塞联合刮宫术治疗子宫切口妊娠的临床应用[J]. 临床放射学杂志, 2009, 28(5): 700-703.
15.	赵文荣, 杨丹. 宫颈妊娠的血管性介入治疗[J]. 复旦学报(医学版), 2008, 35(3): 468-470.

1. 曹泽毅. 中华妇产科学[M]. 第2版. 北京: 人民卫生出版社, 2004: 1450-1459.
2. 谢欢宇, 方芳. 宫颈妊娠[J]. 实用妇产科杂志, 2009, 25(4): 196-198.
3. Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
4. 罗红, 杨太珠, 郭文琪, 等. 子宫峡部妊娠的超声诊断价值[J]. 中国医学影像技术, 2005, 21(2): 324-325.
5. 何敏, 杨太珠. 宫颈妊娠的早期诊断及治疗进展[J]. 临床超声医学杂志, 2007, 9(7): 424-426.
6. 王世阆. 剖宫产瘢痕部位妊娠[J]. 实用妇产科杂志, 2009, 25(4): 195-196.
7. 张丽娟, 向华, 丁依玲, 等. 剖宫产后子宫切口妊娠绒毛植入11例临床分析[J]. 实用妇产科杂志, 2008, 24(7): 440-441.
8. 孔芬英, 王艳芬, 高丽杰, 等. 宫颈妊娠10例诊治分析[J]. 中国计划生育学杂志, 2008, (3): 175-176.
9. 朱亚非, 何木佳. 与药物保守治疗输卵管妊娠相关的循证医学评价[J]. 中国实用妇科与产科杂志, 2007, 23(11): 880-882.
10. Alleyassin A, Khademi A, Aghabosseinim M, et al. Comparison of success rates in the medical management of ectopic pregnancy with single-dose and multiple-dose administration of methotrexate: a prospective, randomized clinical trial[J]. Fertil Steril, 2006, 85(5): 1661-1666.
11. 丁霞, 石钢, 杨太珠, 等. 剖宫产后切口妊娠的临床诊治分析[J]. 实用妇产科杂志, 2006, 22(5): 306-308.
12. 刘菊红, 李坚. 10年子宫腔下部妊娠病例的回顾性分析[J]. 首都医科大学学报, 2006, 27(1): 113-116.
13. 邓新粮, 何小丽, 肖松舒. 剖宫产后子宫切口部位妊娠保守治疗16例疗效分析[J]. 实用妇产科杂志, 2008, 24(6): 372-373.
14. 代新学, 游海燕, 周丹. 子宫动脉栓塞联合刮宫术治疗子宫切口妊娠的临床应用[J]. 临床放射学杂志, 2009, 28(5): 700-703.
15. 赵文荣, 杨丹. 宫颈妊娠的血管性介入治疗[J]. 复旦学报(医学版), 2008, 35(3): 468-470.

West China Medical Journal

Clinical Analysis of Ectopic Pregnancy in the Uterine

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