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近10年异位妊娠诊断及治疗的变化 附1 970例分析 |
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冯炜炜 曹斌融 李勤
【摘要】 目的 探讨近10年异位妊娠发生率及诊断治疗方法的变化。方法 按每2年为1个时间段回顾分析我院1987年1月至1996年12月间1 970例异位妊娠的诊治情况。结果 (1) 异位妊娠与同期分娩数之比由1987至1988年的1.0∶42.4上升为1995至1996年的1.0∶6.6。(2) 诊断技术有改进，剖腹探查的比例下降，而经电视腹腔镜、超声结合血、尿绒毛膜促性腺激素(β-hCG)检测确诊者增多。确诊时间缩短，1987至1988年平均为(6.5±0.7) d，1995至1996年平均为(3.7±0.2) d（P<0.05）。(3) 经腹输卵管切除术比例下降，腹腔镜手术、保守治疗比例上升。(4) 保守性手术成功率100.0%。药物保守治疗方式多样，成功率约80.0%～85.0%左右。期待治疗成功率100.0%。结论 异位妊娠发生率增高。腹腔镜技术的应用、超声结合敏感的β-hCG测定缩短了确诊时间。剖腹手术减少，腹腔镜手术及保守治疗是目前异位妊娠治疗的趋势。
【关键词】 妊娠，异位；诊断；治疗；发病率
Advances in Diagnosis and Treatment of Ectopic Pregnancy during the Past Ten Years
FENG Weiwei, CAO Binrong, LI Qin.
（Depontment of Gynecology, Obstetrics and Gynecology Hospital of Shanghai Medical University, Shanghai 200011， China）
【Abstract】 Objective To investigate the changes of diagnosis and treatment of ectopic pregnancy （EP）during the past ten years. Methods Medical records of 1 970 cases with EP seen in our hospital from Jan.1987 to Dec.1996 were collected and analyzed retrospectively. Results (1) The incidence of EP increases from 1.0 per 42.4 labours during 1987 ～ 1988 to 1.0 per 6.6 labours in 1995～1996. (2) Diagnosis was confirmed more by television laparoscopy, transvaginal ultrasonography and sensitive human chorionic gonadotropin-beta subunit assay rather than loparotomy and with a shorter period, (6.5 ±0.7) days in 1987～1988 versus (3.7±0.2)days in 1995～1996. (3) The choice of treatment was more conservative or through laparoscopic surgery than abdominal salpingectomy. (4) The success rate of conservative surgery expectant management reached 100.0% and medical treatment with a variety of choices around 80.0%～85.%. Conclusions Although the incidence of EP increased, with the improvement of diagnostic approaches, patients were detected at an earlier stage and possible to be treated more conservatively.
【Key words】 Pregnancy, ectopic; Diagnosis; Therapy；[1] [2] [3] 下一页
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