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目的提高对临床表现不典型异位妊娠的认识,减少误诊、漏诊。方法回顾性分析我院收治的52例无明确停经史的异位妊娠的临床资料。结果 52例均否认停经史,49例以阴道流血和(或)腹痛为主诉就诊,3例以上腹部不适及恶心、呕吐就诊。首诊于妇产科42例,外科8例,内科2例,其中14例(26.9%)误诊,误诊为急性阑尾炎6例,卵巢黄体破裂3例,急性胃炎2例,肠梗阻、输尿管结石、附件囊肿蒂扭转各1例。34例经手术确诊并治疗,18例经B超、血绒毛膜促性腺激素检查并结合临床表现确诊后予保守治疗。52例均痊愈。结论无明确停经史的异位妊娠临床易发生误漏诊,提示对育龄期急腹症患者,无论有无阴道流血和停经史,均应排除异位妊娠的可能。
Objective To improve the understanding of atypical clinical ectopic pregnancy, reduce misdiagnosis and missed diagnosis. Methods The clinical data of 52 cases of ectopic pregnancy without definite history of menopause in our hospital were retrospectively analyzed. Results 52 cases all denied the history of menopause, 49 cases were mainly complained of vaginal bleeding and / or abdominal pain, and 3 cases had abdominal discomfort and nausea and vomiting. The first diagnosis of obstetrics and gynecology in 42 cases, surgery in 8 cases, 2 cases of internal medicine, 14 cases (26.9%) were misdiagnosed as misdiagnosed as acute appendicitis in 6 cases, ovarian lupus rupture in 3 cases, acute gastritis in 2 cases, intestinal obstruction, ureteral calculi, Annex cyst torsion in 1 case. 34 cases were diagnosed and treated surgically, and 18 cases were diagnosed conservatively after being diagnosed by B ultrasound and blood chorionic gonadotropin combined with clinical manifestations. 52 cases were cured. Conclusions Ectopic pregnancy without definite history of menopause is prone to misdiagnosis. It suggests that the possibility of ectopic pregnancy should be excluded for patients with acute abdomen during childbearing age, regardless of the history of vaginal bleeding and menopause.