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目的探讨输卵管妊娠的高危因素和早期诊断方法。方法回顾620例未破裂输卵管妊娠患者的临床资料,并与同期早期宫内妊娠流产890例进行对照研究。结果输卵管妊娠的发生与未婚、多次宫腔操作史、盆腔炎及盆腔手术史、异位妊娠史、不孕症史的关系密切。观察组宫颈举痛、附件包块、附件压痛明显高于对照组。TV-CDE显示输卵管妊娠中,胚胎型、孕囊型、包块型的R I值分别位0.37、0.50、0.61,均呈现高流低阻型血流,且三组差异有统计学意义,各型R I值均与β-HCG及P水平呈负相关。结论未婚、多次宫腔操作史、盆腔炎及盆腔手术史、异位妊娠史、不孕症史是形成输卵管妊娠的高危因素。TV-CDE检查与血β-HCG、P相结合,进行动态观察,是输卵管妊娠早期诊断的有效方法。
Objective To investigate the risk factors and early diagnosis of tubal pregnancy. Methods The clinical data of 620 patients with unruptured tubal pregnancy were retrospectively analyzed and compared with 890 cases of early pregnancy intrauterine abortion in the same period. Results Tubal pregnancy occurred unmarried, multiple uterine operation history, history of pelvic inflammatory disease and pelvic surgery, ectopic pregnancy history, the history of infertility are closely related. Observation group cervical pain, annex mass, attachment was significantly higher than the control group tenderness. TV-CDE showed that the RI values of embryo, gestational sac and mass in tubal pregnancy were 0.37,0.50,0.61 respectively, showing high-flow and low-resistance blood flow, and there was significant difference among the three groups RI values were negatively correlated with β-HCG and P levels. Conclusions Unmarried, multiple uterine operation history, history of pelvic inflammatory disease and pelvic surgery, history of ectopic pregnancy, history of infertility is the risk factors for the formation of tubal pregnancy. TV-CDE examination and blood β-HCG, P combination of dynamic observation, tubal pregnancy is an effective method of early diagnosis.