异位妊娠48例误诊临床分析
误诊,,异位妊娠；误诊；临床分析,1资料与方法,2分析结果,3讨论,参考文献】
【摘要】 目的 探讨异位妊娠误诊的原因，提高异位妊娠早期诊断。方法 对1989年1月～2004年11月在我院收治的异位妊娠178例中48例异位妊娠误诊做回顾性分析，寻找导致误诊的因素。结果 48例病例中，误诊为宫内早期妊娠23例，先兆流产3例，盆腔炎2例，子宫内膜炎2例，黄体破裂、卵巢囊肿扭转各1例，急性阑尾炎6例，胆囊炎1例，急性胃肠炎9例。结论 内外科对育龄妇女的急腹症勿忘询问停经史和不规则阴道流血史；妇产科急腹症和早孕疑似病例重视血、尿HCG和阴道B超检测综合分析是降低异位妊娠漏诊率和误诊率的关键。【关键词】 异位妊娠；误诊；临床分析
A clinical analysis of 48 cases of heterotopic pregnancy leading to misdiagnosis
CHEN Xiang-feng,WU Qi-lin,FAN Rui-yu,et al.
Department of Gynecology and Obstetrics,Shanghai Second Peoples Hospital,Shanghai 200011,China
【Abstract】 Objective To investigate the causes of misdiagnosis of heterotopic pregnancy and to improve the early diagnosis of the disease.Methods We retrospectively reviewed and analyzed the hospital records of 178 consecutive cases of heterotopic pregnancy hospitalized from Jan.1989 through Nov.2004,of which 48 had been misdiagnosed on admission,and found out the factors that readily led to misdiagnosis.Results Out of the 48 cases,23 had been misdiagnosed as early entopic pregnancy;3,as threatened abortion;2,as pelvic inflammation;2,as endometritis; 1,as rupture of corpus luteum and torsion of ovarian cyst each;6,as acute appendicitis;1,as cholecystitis and 9,as acute gastroenteritis.Conclusion Physicians and surgeons should not forget to ask their female patients in childbearing age with acute abdomen about the history of amenorrhea and irregular vaginal bleeding.Paying due attention to blood and urine HCG determination,intravaginal B ultrasonography and a comprehensive analysis in the diagnosis of gynecological acute abdomen and suspected early pregnancy is the key to the reduction of missed and incorrect diagnosis of heterotopic pregnancy. ......
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