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目的:提高异位妊娠诊断的准确率,加强对外地来京育龄妇女的健康教育。方法:对1988年1月～2007年12月20年间在北京天坛医院妇科病房住院治疗的1122例异位妊娠患者的临床资料进行回顾性分析,并对其中144例误诊病例进行相关资料的统计比较。结果:误诊胃肠炎16例,阑尾炎9例,胆囊炎1例,妇科疾病118例(保胎治疗27例,不全流产行清宫术16例,早孕行人流或药流34例,盆腔炎30例,恶性肿瘤2例,月经失调9例)。结论:近10年异位妊娠发生率明显升高,尤其是外来人口的异位妊娠发生率明显高于本市人口,但误诊率没有明显变化,其中异位妊娠误诊为妇科疾病的发生率最高。因此详细询问病史,仔细分析病情变化,充分认识不典型异位妊娠的各种表现,结合B超、HCG及后穹窿穿刺等辅助检查可提高诊断准确率。
Objective: To improve the accuracy of diagnosis of ectopic pregnancy and strengthen the health education of women of childbearing age in other places. Methods: The clinical data of 1122 cases of ectopic pregnancy hospitalized in gynecology ward of Beijing Tiantan Hospital from January 1988 to December 2007 were analyzed retrospectively, and statistics of 144 cases of misdiagnosis were compared among them . Results: Misdiagnosed gastroenteritis in 16 cases, appendicitis in 9 cases, cholecystitis in 1 case, gynecological disease in 118 cases (miscarriage treatment in 27 cases, incomplete abortion in 16 cases, abortion in early pregnancy or drug flow in 34 cases, pelvic inflammatory disease in 30 cases, 2 cases of malignant tumor, menstrual disorders in 9 cases). Conclusion: The incidence of ectopic pregnancy in the recent 10 years was significantly higher, especially the incidence of ectopic pregnancy among migrants was significantly higher than that of the city population, but the misdiagnosis rate did not change significantly. The misdiagnosis rate of gynecological diseases was the highest in ectopic pregnancy . Therefore, detailed history, careful analysis of disease changes, fully understand the various manifestations of atypical ectopic pregnancy, combined with B-ultrasound, HCG and culdocentesis and other auxiliary examination can improve the diagnostic accuracy.