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目的探讨卵巢妊娠的病因、临床特征、诊断及治疗方法。方法对深圳市第五人民医院2005年12月～2012年1月收治的48例卵巢妊娠临床资料进行回顾性分析。结果卵巢妊娠占同期异位妊娠的1.37%,其中68.8%有人工流产史,27.1%有腹部手术史,18.8%放置宫内节育器,8.3%为体外受精-胚胎移植术后。卵巢妊娠主要症状是腹痛(93.8%),77.1%有停经史,35.4%有阴道流血,39.6%出现晕厥休克。仅2例患者术前确诊,所有患者均手术治疗,其中39例行腹腔镜手术。结论卵巢妊娠近年来发病呈上升趋势,与宫腔操作、盆腔炎、腹部手术、体外受精-胚胎移植术及放置宫内节育器有关。因临床表现缺乏特异性,术前很难诊断。治疗以手术为主。腹腔镜手术具有创伤小,出血少,术后恢复快,住院时间短的特点,是安全、有效的治疗方法,值得推广。
Objective To investigate the etiology, clinical features, diagnosis and treatment of ovarian pregnancy. Methods The clinical data of 48 cases of ovarian pregnancy admitted to Shenzhen Fifth People’s Hospital from December 2005 to January 2012 were analyzed retrospectively. Results Ovarian pregnancy accounted for 1.37% of the ectopic pregnancy in the same period, of which 68.8% had a history of abortion, 27.1% had a history of abdominal surgery, 18.8% placed an IUD, and 8.3% after IVF. The main symptoms of ovarian pregnancy were abdominal pain (93.8%), 77.1% had a history of menopause, 35.4% had vaginal bleeding, 39.6% had a syncope shock. Only 2 patients were diagnosed preoperatively and all patients underwent surgery, of which 39 patients underwent laparoscopic surgery. Conclusion The incidence of ovarian pregnancy in recent years is on the rise, and the uterine cavity operation, pelvic inflammatory disease, abdominal surgery, in vitro fertilization and embryo transfer and placement of IUD. Because of the lack of specificity of clinical manifestations, preoperative diagnosis is difficult. The main treatment is surgery. Laparoscopic surgery has the characteristics of less trauma, less bleeding, quick recovery after surgery and shorter hospital stay, which is safe and effective and is worth promoting.