宫内外同时妊娠2例

例1,32岁,维族,孕2产1。停经51d,下腹部坠痛4h,急诊入院。平素月经规律,无明显诱因4h前突然出现下腹部坠痛,伴恶心、呕吐。查体：T36．7℃;P100次／min;     

宫内外同时妊娠2例

1临床资料例1，25岁，G3P1，因停经38天，下腹痛1天，加重3小时，于2000年7月24日下午3时入院。查体：T37.2℃，P120次/min，BP90/50mmHg，贫血貌，腹略膨隆，全腹压痛反跳痛，移动性浊音(+)。妇科检查：外阴已婚已产式，阴道通畅，宫颈光滑，后穹窿举痛，子宫饱满，后位，有压痛，双附件未触及明显包块。尿妊娠试验(+)。以“宫外孕破裂”急诊行探查术。术中见右侧输卵管峡部有1cm破口，有活动性出血，行右侧输卵管切除术，手术顺利，清除积血及血块共1400ml，术中输血800ml。病理为右侧输卵管妊娠破裂。术后无阴道流血，7天后查尿HCG仍…     

IUD合并宫内宫外同时妊娠一例

患者 3 6岁 ,因“停经 5 6天 ,要求终止妊娠”于2 0 0 1年 6月 1日 6ｐｍ来我院行人工流产术。末次月经 2 0 0 1年 4月 5日 ,停经后无明显早孕反应 ,测尿ＨＣＧ阳性 ,停经后无阴道流血和腹痛。平时月经规律 ,无痛经史 ,于 8年前宫内置环。就诊后行腹部摄片见盆腔中央金属单环距耻骨联合上 3ｃｍ ,遂行人流术 ,妇科查宫颈着色 ,子宫前位如孕5 0 +天大 ,质中 ,活动好 ,双附件区末触及明显包快。探测官腔 1 1ｃｍ ,吸宫时取出一枚 2 3号金属单环 ,刮出组织约 6 0ｇ送病检 ,术后宫腔 7ｃｍ ,术中出血约 5 0ｍｌ,患者无不适 ,自行回家。术后 3天…     

宫内外同时妊娠3例

例 1,患者 2 6岁 ,停经 46ｄ ,下腹剧痛 6ｈ于 1991年 6月 3 0日入院 ,查尿ＨＣＧ阳性 ,Ｂ超提示 :宫内未见胚囊 ,子宫直肠窝液性暗区 3 2ｃｍ× 4 1ｃｍ ,左附件 3 2ｃｍ× 2 1ｃｍ不均质回声 ,查下腹压痛 ,反跳痛 ,以左侧为重 ,考虑宫外孕 ,立即行剖腹探查术 ,术中见腹腔积血 80 0ｍｌ ,左输卵管壶腹部妊娠流产 ,行左输卵管部份切除术 ,术后 6ｄ患者仍感恶心 ,未引起重视 ,术后4个月一直未来月经 ,因感到胎动到医院就诊 ,诊断为中期孕 ,行引产术。　　例 2 ,患者 3 2岁 ,停经 43ｄ ,下腹痛 1ｄ多 ,于 1995年 4月入院 ,诊断为“宫外孕”…     

Anginogenesis of Eutopic and Ectopic Endometria in Endometriosis

Summary:In order to study the angiogenesis in endometriosis,the samples of eutopic and ectopic endometria from patients with endometriosis were quantitatively analyzed by color morphometric imagesystem(CMIS)for vascular surface area,and by examining endometrial blood vessel for microvesseldensity(MVD).The results showed that within each menstrual phase the vascular surface area andMVD were significantly higher in ectopic endometria with endometriosis than those in eutopic en-dometria with endometriosis or normal endometrium(P<0.05).It is concluded that angiogenesismight be involved in the development of endometriosis.     

Co-existing tubal ectopic pregnancy and appendicitis--a case report

Appendicitis in pregnancy has a well documented high morbidity due to the difficulty in diagnosis. However, synchronous ectopic pregnancy and appendicitis is a rare event. This report describes the case of a 22-year-old lady of Bangladeshi origin who presented with both these conditions. The importance of prompt diagnosis and early surgical intervention, the inherent difficulties in diagnosis and the possible interrelated aetiological factors are discussed.     

Undiagnosed case of term heterotopic pregnancy with ectopic abdominal pregnancy

Heterotopic pregnancy involves coexisting intra-uterine and extra-uterine gestations. The incidence for natural uninduced pregnancy is 1 in 30,000 pregnancies. However the incidence is increasing with ovulation induction and artificial reproductive techniques. In more than 90% heterotopic pregnancies, the ectopic implantation is in the fallopian tube. A case of undiagnosed term heterotopic pregnancy in a 26-year-old primigravida is reported. She was referred from a practising obstetrician as a case of term twin pregnancy. Her regular antenatal records suggested intra-uterine growth restriction in one foetus of the twin. After confirmation of findings with ultrasound she was taken for emergency caesarean section. Heterotopic pregnancy was diagnosed on opening the abdomen. The term abdominal pregnancy was managed successfully. Although remained undiagnosed till term, good maternal and perinatal outcome was noted with survival of both the babies.     

人子宫内膜异位症异位及在位内膜间质细胞分离与培养

目的：建立子宫内膜异位症（EMs）异位、在位内膜间质细胞的体外细胞模型,实时观察间质细胞形态变化。方法胶原酶消化异位、在位内膜组织,二次筛网过滤结合低速离心法分离纯化间质细胞,应用免疫细胞化学染色进行细胞鉴定,并进行传代培养,观察细胞生长状况及细胞形态差异。结果培养成功率91．3％,间质细胞纯度达95％;异位间质细胞9代内、在位及对照组间质细胞11代内,细胞形态及活性并无明显改变。结论子宫内膜间质细胞可为子宫内膜异位症研究提供较好的细胞模型。     

异位?在位和正常子宫内膜基质细胞分泌RANTES水平比较

目的:比较子宫内膜异位症患者异位内膜、在位内膜和正常子宫内膜分泌RANTES的水平,以了解盆腔局部趋化巨噬细胞浸润的始动因素.方法:不同浓度(5、10、20 ng/ml)的IL-1β刺激培养异位内膜基质细胞;选择最佳刺激浓度的IL-1β刺激培养异位内膜、在位内膜和正常内膜基质细胞,在不同的时间点取培养上清ELISA检测RANTES水平.结果:10 ng/ml的IL-1β是刺激异位内膜基质细胞分泌RANTES的最佳浓度;异位内膜基质细胞分泌RANTES的水平显著高于在位内膜和正常内膜(P<0.01);刺激培养60 h后,在位内膜RANTES分泌量较正常内膜显著增加(P<0.05).结论:EMS患者的在位内膜与正常内膜相比,其生物学特性已经发生了改变,盆腔内的异位内膜、巨噬细胞和细胞因子形成了一个炎症反馈环,促进了异位内膜的种植、生长和局部炎症的发生.     

正常与异位子宫内膜Bcl-2与PCNA的表达

目的：探讨B细胞淋巴瘤/白血病-2(Bcl-2)蛋白和增殖细胞核抗原（PCNA）蛋白与正常及异位子宫内膜的关系。 方法：应用免疫组化法检测46例正常月经周期子宫内膜和15例卵巢子宫内膜异位症患者的异位子宫内膜中的Bcl-2蛋白和PCNA蛋白。 结果：Bcl-2蛋白和PCNA蛋白在正常月经周期子宫内膜增生期升高(两组均为61.5%),分泌期低落(22.2%和5.5%),月经期消失(0和33.3%);在异位内膜中的表达(均为100%)高于增生期（P<0.05）。 结论：正常月经周期子宫内膜中Bcl-2蛋白和PCNA蛋白表达有周期性变化,且与异位子宫内膜中的表达不同,异位子宫内膜通过多种方式获得生存优势。