特殊部位异位妊娠的临床分析

目的 探讨特殊部位（如子宫颈、输卵管间质部等）异位妊娠的早期诊断与预后的关系，及与重复异位妊娠相关的因素。方法 对特殊部位的异位妊娠及重复异位妊娠进行回顾性分析。结果 回顾分析201例异位妊娠，其中宫颈妊娠1．49％（3／201），输卵管间质部妊娠2．98％（6／201），卵巢妊娠1．00％（2／201），重复异位妊娠4．48％（9／201）。宫颈妊娠均B超早期诊断全部保守治疗成功，3例间质部妊娠、2例卵巢妊娠也经B超检查而早期发现及时处理，避免了大出血及休克的发生。重复异位妊娠中第一次异位妊娠前有剖宫产史者占77．78％。第二次异位妊娠腹腔内出血明显少于第一次。结论 特殊部位异位妊娠早期诊断预后较好，B超对其早期诊断有重要价值，重复异位妊娠与剖宫产的关系有待于进一步探讨。

Clinical Study of Ectopic Pregnancy at Special Sites

Objective To detect the relationship between early diagnosis and prognosis of ectopic pregnancies at special sites such as cervix or interstitial portion of the fallopian tube, and also the factors related to repeat ectopic pregnancy. Methods Two hundred and one patients with ectopic pregnancy were retrospectively studied Results Cervical pregnancies occured in 3 patients (1.49%), interstitial portion pregnancies 6(2.98%), ovarian pregnancies 2(1.00%), and repeat ectopic pregnancies patients 9 (4.48%). Three cervical pregnancies were ultrasonically diagnosed in early stage and cured conservatively. Three interstitial portion pregnancies and 2 ovarian pregnancies were diagnosed at an early date and managed in time to avoid a severe result. 77.78% (7/9) of repeat ectopic pregnancies had a history of Cesarean Section at the first ectopic pregnancy. Peritoneal bleeding in the former ectopic pregnancy was much less than the later one. Conclusion Early diagnosis can improve prognosis in ectopic pregnancy, especially at special sites. Sonographic scan is of great value in early diagnosis. Anyhow relationship of repeat ectopic pregnancy with Caesarean Section needs further study.