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异位妊娠,又称宫外孕,是妇科常见的急腹症,近年来发病明显增加。B超检查的应用使诊断率大有提高。但其临床表现变化多端、声像图复杂多样,诊断仍有一定困难。本文总结了我院经手术和病理证实为输卵管妊娠、术前均行B超检查的病例172例,分析其临床资料及声像图特征,并对漏诊、误诊的原因进行分析,以进一步提高超声对本病的诊断水平。 资料与方法 本组172例患者,年龄19～41岁,小于25岁36例,大于35岁16例,平均28.1±4.1岁;明显停经史150例(87.2％),停经时间为31～110天;不规则阴道流血162例(73.2％),2例阴道流出物有脓臭味;腹痛160例(93.0％);妇检子宫增大37例(18.0％),宫颈举痛、附件区压痛137例(79.7％),附件区扪及不同质地包块51例(30％),子宫漂浮感24例(14％);尿HCG阳性157例(91.5％),可疑阳性9例,阴性4例;白经胞总数和中性粒细胞增高12例;后穹窿穿刺阳性85例(49.3％);该组患者中,12例以人流术后阴道流血或腹痛就诊,9例人流时未见绒毛,6例人流情况不详;7例行双侧输卵管结扎术,26例宫内放置节育器,11例为不孕症首次怀孕。
Ectopic pregnancy, also known as ectopic pregnancy, gynecological acute abdomen is common in recent years, the incidence increased significantly. The application of B-ultrasound has greatly improved the diagnostic rate. However, its clinical manifestations vary, complex and diverse sonography, the diagnosis is still some difficulties. This article summarizes the surgical and pathological confirmed by our hospital for tubal pregnancy, preoperative B-ultrasound examination of 172 cases, analysis of clinical data and sonographic features, and misdiagnosis of the reasons for the analysis to further improve the ultrasound The diagnosis of the disease level. Materials and Methods This group of 172 patients, aged 19 to 41 years, less than 25 years old in 36 cases, more than 35 years old in 16 cases, an average of 28.1 ± 4.1 years; obvious menopause in 150 cases (87.2%), menopause time was 31 to 110 days ; Irregular vaginal bleeding in 162 cases (73.2%), 2 cases of vaginal effusion purulent odor; abdominal pain in 160 cases (93.0%); women’s uterine enlargement in 37 cases (18.0%), cervical pain, attachment area tenderness 137 (79.7%), 51 cases (30%) of palpable masses and 24 cases of uterine floating (14.5%) were palpable in the attachment area, 157 cases (91.5%) were HCG positive, 9 were suspicious and 4 were negative. The total number of white blood cells and neutrophils in 12 cases; posterior fornix puncture in 85 cases (49.3%); in this group of patients, 12 patients were treated by vaginal bleeding after abortion or abdominal pain, 9 cases of human flow no villi, 6 Cases of abortion is unknown; 7 cases of bilateral tubal ligation, intrauterine placement of 26 cases of IUD, 11 cases of infertility for the first time pregnant.