腹腔镜治疗异位妊娠58例临床分析

目的：总结腹腔镜手术治疗异位妊娠的临床疗效和体会。方法：对本院2005-01～2008-12腹腔镜手术治疗异位妊娠患者58例的临床资料进行回顾性分析。结果：手术成功率100%。平均手术时间（20～40）min。结论：腹腔镜手术治疗异位妊娠具有安全、快速、痛苦小、疗效好的特点。     

腹腔镜手术治疗异位妊娠98例分析

由于诊断技术的提高及腹腔镜技术在妇科的展开，使异位妊娠得到了早期诊断及治疗。现将我院2000-01～2003-01腹腔镜手术治疗异位妊娠的情况总结如下。     

异位妊娠腹腔镜术后持续性异位妊娠1例

患者,33岁,孕1产0,因“停经46 d,阴道不规则流血伴右下腹痛1 d”,于2006-01-14入院。患者停经38 d化验尿HCG弱阳性,血HCG 102 U/L,入院前1天复查血HCG327 U/L,B超示:宫后方积液(8 mm);右侧卵巢小囊肿(28 mm×32 mm)。入院第2天复查血HCG 2 168.32 U/L,B超示:宫后方积液稍增多(10 mm),妇查:宫颈举痛阳性,右附件增粗,压痛明显,后穹窿穿刺抽出不凝血2 m l。初步诊断:异位诊断,于次日行腹腔镜下探查术。术中见盆腹腔积血约300 m l,子宫大小形态正常,右输卵管壶腹增粗约2 cm×1 cm,紫蓝色,右卵巢增大,见一约3 cm×2 cm大小囊肿,术中诊断:右输卵管壶腹部妊娠;右卵巢囊肿。行腹腔镜下右输卵管妊娠开窗取胚术+右卵巢囊肿剥除术。术后病检报:送检血块组织中未见绒毛;(右)卵巢黄体囊肿。术后第3天复查HCG 1 157.44 U/L,患者无特殊不适,并于次日坚决要求出院。出院后一周复查HCG 2 354.42 U/L,考虑持续性异位妊娠,予米非司酮、甲氨蝶呤治疗,HCG曾一度降低后持续回升,最高达18 356.44 U/L,出...     

腹腔镜手术治疗休克型异位妊娠32例

对于异位妊娠伴有低血容量性休克者,因其血流动力学不稳定,能否做腹腔镜手术存在争议。2002年以来,我们应用腹腔镜手术治疗休克型异位妊娠32例,疗效满意。     

腹腔镜手术治疗异位妊娠的临床研究

目的：探讨腹腔镜手术治疗异位妊娠的临床疗效。方法：选择异位妊娠120例,随机分为观察组与对照组各60例,观察组采用腹腔镜手术,对照组采用传统开腹手术,比较两组手术时间、术中出血量、术后排气时间、术后住院天数及术后胃肠功能恢复情况等。结果：观察组手术时间（25.4±9.1）min,术中出血量（33.7±18.6）ml,术后排气时间（37.2±12.1）h、下床时间（18.4±6.5）h、住院天数（4.3±0.5）天;对照组手术时间（64.8±22.9）min,术中出血量（126.1±62.1）ml,术后排气时间（49.0±14.5）h、下床时间（47.3±12.1）h、住院天数（7.1±0.4）天;两组比较,均差异非常显著（P〈0.01）。结论：腹腔镜手术治疗异位妊娠具有快速、安全、有效、恢复快等优点。     

腹腔镜与开腹手术治疗异位妊娠疗效对比分析

目的试验比较并分析腹腔镜与开腹手术治疗异位妊娠的疗效。方法选取异位妊娠80例患者,随机平均分为试验组与对照组。试验组给予腹腔镜治疗,对照组给予开腹手术治疗。比较两组患者平均手术时间、术中出血量、输卵管通畅情况及平均住院时间。结果试验组患者在平均手术时间、术中出血量、输卵管通畅情况及平均住院时间方面均优于对照组,P〈0.05,差异有统计意义。结论腹腔镜与开腹手术治疗异位妊娠疗效相比出血较少、创伤较小、输卵管通畅率较高,住院时间缩短,优点明显。     

应用腹腔镜技术治疗异位妊娠148例临床体会

据统计,异位妊娠与正常妊娠之比为1:50～300[1].随着腹腔镜手术在妇产科领域的广泛应用,腹腔镜技术治疗异位妊娠正逐渐取代传统的开腹手术,我院应用腹腔镜技术对148例异位妊娠患者行手术治疗,成功率100%.现报告如下.     

特殊类型异位妊娠腹腔镜手术的临床分析

目的:探讨腹腔镜在特殊类型异位妊娠治疗中的临床价值。方法:对319例腹腔镜下不同类型异位妊娠(其中特殊类型33例)手术治疗的病人进行回顾性分析。结果:319例异位妊娠患者,317例康复出院,2例术后出现持续性异位妊娠,成功率为99.37%。33例特殊类型异位妊娠均在腹腔镜下完成手术,无1例中转开腹,结论:在设备完善、技术熟练和准备充分的基础上,可对各种特殊类型异位妊娠试行腹腔镜手术。     

腹腔镜治疗有妇产科手术史的异位妊娠76例

目的：探讨腹腔镜治疗有妇产科手术史的异位妊娠患者的可行性和安全性。方法研究对象为126例有妇产科手术史、并再次接受腹腔镜治疗的异位妊娠患者,其中有1次妇产科手术史者84例,有2次及以上妇产科手术史者42例。比较1次手术史、2次及以上手术史患者术中情况及术后并发症。结果126例患者中,手术成功112例,中转开腹14例,发生并发症7例。结论腹腔镜治疗有妇产科手术史的异位妊娠手术成功率高,1次手术史有效性与安全性更高。     

Sonographic demonstration of heterotopic pregnancy: report of two cases

We described two patients with heterotopic pregnancy. In one patient the transabdominal sonographic findings were non-specific and laparoscopy was required for diagnosis. In the second patient transabdominal sonographic findings suggested a diagnosis of heterotopic pregnancy. Endovaginal sonography confirmed this by allowing visualization of the live extrauterine gestation.     

Cyst formation in gastric heterotopic pancreas: report of two cases

Cyst formation is an uncommon pathologic finding in heterotopic pancreas. It is sometimes reported in a duodenal location but very rarely in a gastric location and leads to very large lesions of unusual endoscopic and radiographic appearance. Two cases of gastric heterotopic pancreas are described in which cystic zones in the gastric wall were found at preoperative ultrasound or computed tomography.     

异位妊娠病因及保守治疗中的监测

异位妊娠 (EctopicPregnancyEP)是指受精卵着床于子宫体腔以外的其部位的妊娠 ,习称宫外孕。它是妇产科常见的急诊之一 ,若不及时诊断和积极抢救 ,可危及生命。异位妊娠是在妊娠早期导致死亡的首要疾病之一 ,也是妇科急诊的主要难题之一。据美国疾病防治及控制中心统计 ,从 1972～1992年 ,异位妊娠的发病率增加了 4倍 ,占所有妊娠的2 0 % 〔1〕。近 2 5年来 ,国内外文献报道 ,异位妊娠呈明显上升趋势 ,可能与性病、流产等高危因素增加和助孕技术的开展有关。尽管发病率上升 ,但实际病死率却呈下降趋势 ,且治疗也有了明显改进 ,从经腹输卵…     

Endovascular treatment of cerebral artery aneurysms during pregnancy: report of three cases

Historically, surgical management of cerebral aneurysms during pregnancy has been controversial. Debate originally focused on early versus late intervention, before or after delivery of the fetus. More recently, treatment has centered on rapid intervention. We describe the endovascular treatment of cerebral artery aneurysms with Guglielmi detachable coils in three pregnant women.     

经子宫动脉化疗栓塞治疗异位妊娠35例观察

目的探讨经子宫动脉化疗栓塞治疗异位妊娠的临床效果。 方法对35例异位妊娠患者利用标准的动脉造影技术,找到异位妊娠的供血血管,经导管向子宫动脉灌注化疗药甲氨蝶呤（MTX）或氟尿嘧啶（5-FU）,然后选择710～1000 μm的明胶海绵颗粒栓塞子宫动脉。术后观察患者的临床表现、生命体征、盆腔包块情况以及患者的绒毛膜促性腺激素（β-HCG）变化情况。 结果35例患者均一次性插管,成功35例,成功率为100%。β-HCG呈进行性下降,均在1个月左右下降至正常值(<2.9 IU/L),月经在术后1～2个月恢复正常。 结论经子宫动脉化疗栓塞治疗异位妊娠对患者创伤小、成功率高,能预防大出血,增加保守治疗的适应证。     

Endovascular treatment of an acutely ruptured intracranial aneurysm in pregnancy: report of eight cases

Treatment of acutely ruptured intracranial aneurysms in pregnancy represents a clinical challenge requiring a meticulously selected strategy. We report eight cases of ruptured cerebral aneurysms in eight pregnant patients treated safely and effectively via an endovascular approach.     

Quadruplet heterotopic pregnancy; ectopic managed successfully with laparotomy with subsequent viable intrauterine pregnancy: A case report

Heterotopic pregnancy is characterized by a concurrent intrauterine and ectopic pregnancy. It can occur after natural conception, however, it is more common with assisted reproductive techniques , when over one embryo is transferred. Quadruplet heterotopic pregnancy is an exceedingly rare subset. Our case describes a woman who presented to the emergency room with amenorrhea for 9 weeks and lower abdominal pain for 3 days. Transvaginal ultrasound revealed three alive intrauterine fetuses and one left tubal ectopic pregnancy (Quadruplet heterotopic pregnancy). Patient benefited from emergent laparotomy with favorable outcome both in the short term and in the long term. In a patient with a history of assisted reproductive techniques, a high index of suspicion is warranted towards extra-uterine pregnancy. Sonologists should precisely look for adnexal mass. The presence of peritoneal free-fluid requires further investigation. The prognosis of intrauterine fetuses is good, provided the ectopic pregnancy is managed timely and in an effective manner.     

腹部闭合性损伤的腹腔镜诊断和治疗(附116例报告)

目的探讨总结应用腹腔镜技术诊断和治疗腹部闭合性损伤的临床效果.方法 116例腹部闭合性损伤病例在全麻、腹腔镜下行诊断和治疗.结果 116例均于腹腔镜下明确诊断并进行治疗.其中38例出血停止,36例腹腔镜下止血成功,8例腹腔镜行脾切除术.避免剖腹手术82例,占70.7%.结论腹腔镜应用于腹部闭合性损伤的诊断和治疗是可行的,且较腹腔穿刺、腹腔灌洗及剖腹探查简便宜行.     

67Ga uptake at sites of heterotopic calcification: a report of three cases.

Heterotopic calcification occurs commonly in spinal cord injured patients and following joint trauma or surgery. 99Tcm-methylene diphosphonate is useful in the detection of these lesions, many of which are subclinical. Three patients are presented with heterotopic calcification, one with severe hypoxic encephalopathy and two following major trauma. Intense 67Ga uptake within areas of heterotopic calcification was noted in all three patients. Two of the patients also underwent 99Tcm-methylene diphosphonate bone scanning and showed uptake of the bone agent corresponding to the areas of 67Ga uptake. In predisposed patients, heterotopic calcification should be considered in the differential diagnosis of a focal area of 67Ga uptake.     

ESWL治疗泌尿系结石192例报告

作者对体外冲击波碎石术（ESWL）治疗泌尿系结石192例进行了总结。认为CS-2000MP型体外冲击波碎石机由于采用B超定位，避免了X线室位对人体的损害，提高了输尿管中下段结石的碎石成功率，其操作简便，使用电压低，冲击波次数少，安全无痛苦。同时作者对影响碎石的因素和术后并发症的处理进行了探讨，对开展此项治疗技术的医院具有一定的指导意义。