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| 特殊部位异位妊娠的临床特征及超声图像特点 |
| Clinical features and ultrasonic image analysis of ectopic pregnancy at special sites |
| 投稿时间：2019-02-12 |
| DOI：10.3969/j.issn.1000-0399.2019.11.006 |
| 中文关键词: 特殊部位 异位妊娠 超声诊断 |
| 英文关键词: Special sites Ectopic pregnancy Ultrasonic diagnosis |
| 基金项目:上海市科学技术委员会西医引导项目（项目编号：16411963000） |
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| 中文摘要: |
| 目的 探讨特殊部位异位妊娠的临床特征及超声图像特点。方法 回顾性分析上海交通大学医学院附属国际和平妇幼保健院2015年1月至2018年10月经手术证实为特殊部位异位妊娠的302例患者的临床资料，将超声诊断结果与手术结果进行对照分析，以探究特殊部位异位妊娠的临床特征及超声图像特点。结果 302例特殊部位异位妊娠患者术前超声确诊218例，漏、误诊84例，总符合率为72.2%，有腹痛、阴道流血、体外受精-胚胎移植史、异位妊娠史、人流史、剖宫产史、妇科手术史和生育史的比例分别为58.9%、60.6%、26.8%、30.5%、38.7%、34.8%、43.4%和48.3%。宫内外复合妊娠、宫颈妊娠、切口瘢痕妊娠、宫角妊娠、输卵管间质部妊娠和卵巢妊娠的超声诊断率较高（分别为76.0%、82.8%、85.3%、81.3%、65.8%和51.1%），腹腔妊娠、阔韧带妊娠、肌壁间妊娠的超声诊断率较低（均漏诊或误诊）。结论 不同特殊部位异位妊娠的超声图像特点不同。临床应重视患者病史，必要时扩大超声检查范围，或经阴道超声联合腹部超声检查，以降低漏、误诊率。 |
| 英文摘要: |
| Objective To discuss the clinical features and analyze ultrasonic imagesof ectopic pregnancy at special sites. Methods The clinical data of 302 patients with ectopic pregnancy atspecial sites diagnosed by surgery from January 2015 to October 2018 in the International Peace Maternity and ChildHealth Hospital were analyzed retrospectively. Results Among 302 cases of ectopic pregnancy at special sites, 218 cases were diagnosed correctly and 84 cases were misdiagnosis or missed diagnosis byultrasound.The coincidence rate in total was 72.2%(218/302). The rates of abdominal pain, vaginal bleeding, IVF-ET,history of ectopic pregnancy, abortion,caesarean section, gynecologic surgery and childbearing history were 58.9%, 60.6%, 26.8%, 30.5%,38.7%, 34.8%,43.4% and 48.3%, respectively. The diagnostic accordance rates of heterotopic pregnancy, cervical pregnancy, caesarean-section scar pregnancy, uterine horn pregnancy, interstitial tubal pregnancy and ovarian pregnancy were relatively high, which were 76.0%,82.8%,85.3%, 81.3%, 65.8% and 51.1%, respectively. Meanwhile, the diagnostic accordance rates of abdominal pregnancy, broad ligament pregnancy and intramural pregnancy were low, and all cases weremisdiagnosis or missed diagnosis in our research. Conclusion The characteristics of ultrasonic images of ectopic pregnancy at special sites are different. We should pay attention to the clinicalfeatures,expand the scope of scanning, combine TVS with TAS when necessaryso as to reduce the radio of misdiagnosis or missed diagnosis by ultrasound. |
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