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一、病历摘要:患者25岁,因停经46天,阴道流血一周入院,无腹痛及恶心、呕吐等不适,既往月经规律,孕1、产1.5天前曾在院外查尿HCG为阳性反应,入院后查尿HCG半定量>8000IU/L(正常值为<50IU/L).检查:体温36.8℃,脉搏84次/分,血压14/10kPa.心肺正常,肝脾(一).妇检:外阴正常,阴道血染.宫颈光滑,着色、无举痛.后穹窿不丰满,无触痛.子宫稍大于正常.右附件区稍增厚,无压痛.左附件区正常.实验室检查:血红蛋白100g/L、出凝血时间正常.B超检查:子宫形态正常,内部回声均匀,宫内膜线居中,子宫直肠陷窝无积液.左附件区正常,右输卵管峡部可见25.2×21.6mm大小妊娠囊样结构,无胎心搏动.B超提示:右侧输卵管峡部妊娠未破裂型.二、治疗:
First, the medical record summary: 25-year-old patient, due to menopause 46 days, vaginal bleeding a week hospitalization, no abdominal pain and nausea, vomiting and other discomfort, previous menstrual cycle, pregnancy 1, 1.5 days ago in hospital outpatient urinalysis HCG positive reaction, admission Check the urine HCG semi-quantitative> 8000IU / L (normal <50IU / L) .Check: body temperature 36.8 ℃, pulse 84 beats / min, blood pressure 14/10kPa. Cardiopulmonary normal, liver and spleen Normal, vaginal blood stained. Cervical smooth, colored, no pain. After the dome is not full, no tenderness. The uterus slightly larger than normal. Right attachment area slightly thickening, no tenderness. Left attachment area normal. Laboratory tests: Hemoglobin 100g / L, the clotting time is normal.B ultrasound examination: normal uterus, internal echo uniform, endometrial line center, uterine rectal lacunar effusion .Line attachment area is normal, right tubal isthmus 25.2 × 21.6mm size gestational sac Like structure, no fetal heart rate beating .B super tips: the right tubal isthmus not rupture .Second, treatment: