经阴道超声检查对临床治疗宫外孕的指导作用

目的：回顾性分析宫外孕的阴道超声表现与临床治疗方式选择的关系。方法对我院收住的53例宫外孕患者超声图像与治疗方式进行对照。结果53例宫外孕患者中，其中7例异位妊娠未破裂且包块较小又无生育要求的年轻妊娠患者，采用药物保守疗法；20例包块较小（包块直径〈3 cm）且未发生破裂或内出血较少而又有生育要求异位妊娠患者，行腹腔镜开窗术；对16例已破裂及宫外孕范围较大者行开腹手术治疗；2例宫外孕包块大于3 cm者、4例治疗过程中宫外孕包块增大者，其孕囊内探及卵黄囊及胎儿原始心管搏动，经保守治疗失败改开腹手术治疗，视为保守治疗的禁忌症；1例疤痕妊娠患者、1例宫颈妊娠患者，引起子宫大出血难以控制时，采用子宫动脉栓塞术效果较好。结论经阴道超声检查对宫外孕的早期诊断，为临床对宫外孕患者选择何种治疗方案提供可靠的诊断依据，为保守治疗创造了条件，并对保守治疗的监测起着重要作用。

Transvaginal ultrasound guidance for clinical treatment of ectopic pregnancy

Objective Ectopic pregnancy vaginal ultrasound were retrospectively analyzed the relationship and the choice of clini-cal treatment .Methods Admitted in our hospital 53 cases of patients with ectopic pregnancy ultrasound images and the treatment were compared. Results 53 cases of ectopic pregnancy patients, young pregnant patients including 7 cases of unruptured ectopic pregnancy and mass small and no fertility requirements, using conservative drug therapy;20 cases of mass （mass of smaller diame-ter〈3cm） and not broken or bleeding, less and fertility requirements of patients with ectopic pregnancy underwent laparoscopic fenestration, 16 cases have been broken; and the larger scope of ectopic pregnancy underwent operation treatment; 2 cases of ec-topic pregnancy mass greater than 3cm, 4 cases in the treatment of ectopic pregnancy mass increase, the gestational sac in explo-ration and yolk sac and fetal primitive heart tube pulse, modified open operation treatment failure of conservative treatment, con-sidered a contraindication of conservative treatment; 1 cases of scar pregnancy patients, 1 cases of patients with cervical pregnan-cy, difficult to control hemorrhage caused byuterine artery embolization for uterine, better effect. Conclusion Transvaginal ultra-sound examination for early diagnosis of ectopic pregnancy for clinical choose what kind of treatment in patients with ectopic preg-nancy to provide reliable diagnostic basis, create conditions for conservative treatment, and the monitoring of the conservative treatment play an important role.