异位妊娠390例的个体化治疗(1)
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[摘要] 目的:探讨不同妊娠时期与根据不同患者意愿的异位妊娠的个体化处理。方法:回顾性分析2007~2009年在本院诊治的390例异位妊娠患者,对其诊断时所处的妊娠时期及针对患者的不同意愿所进行的治疗手段及效果进行具体分析。结果:390例异位妊娠中,妊娠<60 d(早早孕)331例,妊娠>60 d 59例。流产型184例,破裂型97例。344例病理诊断与术后诊断相符,46例为临床诊断后行保守治疗。行输卵管切除术66例,病灶清除术226例,腹腔镜下完成119例,剖腹完成107例。同时行盆腔粘连松解者297例。死亡1例。发生纠纷2例。结论:异位妊娠患者应予个体化处理,根据不同妊娠时期及患者的生育情况同时结合患者的意愿给予恰当的处理。早早孕期尤其需要慎重,医生的判断及引导性谈话技巧至关重要。
[关键词] 异位妊娠;个体化治疗;早期诊断;医疗纠纷;早早孕
[中图分类号] R714.22[文献标识码] B[文章编号] 1673-7210(2010)06(b)-138-02
Individualized treatment of 390 patients with ectopic pregnancy
DING Hongmei
(Department of Obstetrics and Gynecology, Yunfu People's Hospital of Guangdong Province, Yunfu 527300, China)
[Abstract] Objective: To explore individualized treatment of ectopic pregnancy according to different periods of pregnancy and patient's distinct will. Methods: A retrospective study was done by analyse 390 cases of ectopic pregnancy diagnosed and managed in Yunfu People's hospital from 2007 to 2009, and the treatment means and its efficacy were also analysed based on different pregnant stages and patient's will. Results: Among the 390 cases, the pregnancy time of 331 cases were less than 60 days, which were attributed to very early pregnancy, and other 59 cases were above 60 days. 184 cases were classified as abortion type, 97 cases as rupture type. Pathological diagnosis of 344 cases are consistent with the postoperative diagnosis, and only 46 cases were performed with conservative treatment on the basis of clinical diagnosis. In 390 cases of ectopic pregnancy, 66 cases were carried out with tubal resection, 226 cases with tumor dissection, and 119 cases were completed under laparoscopy, 107 cases with laparotomy, and 297 cases with pelvic adhesions lysis. 1 case was reported death. In addition, 2 case with medical dispute were documented. Conclusion: The treatment of patients with ectopic pregnancy should be individualized according to different periods of pregnancy and the fertility willingness of patients ......
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