CAJ | 학술논문

目的探讨休克型异位妊娠的早期诊断及治疗方法.方法将本院714例出院诊断及病理诊断为异位妊娠的病例按临床特征、手术所见及病理结果分为四组:破裂休克组、破裂组、流产休克组、流产组,比较各组之间的停经时间、腹痛时间、无阴道流血、血β-HCG水平、腹腔内出血量以及血红蛋白水平六项指标的差异情况.结果本研究中各种类型异位妊娠的构成比依次为流产组57.14%(408/714)、破裂组27.17%(194/714)、破裂休克组11.48%(82/714)、流产休克组4.21%(30/714).其中以破裂休克组停经时间最短,无阴道流血的发生率最低,腹痛时间最短,血β-HCG水平最高.流产组的停经时间最长,无阴道流血发生率最低,血β-HCG水平最低.腹腔内出血量、血红蛋白降幅以及输血(浓缩红细胞悬液)量以流产休克组最多.结论停经时间短、腹痛时间短无阴道流血以及血β-HCG水平高可被看为是破裂休克型异位妊娠的预兆,治疗需及时,而流产休克型由于出血速度较慢,患者逐渐耐受,至休克时腹腔内出量已非常大,通常需大量输血方能纠正休克及改善贫血.
목적 탐토휴극형이위임신적조기진단급치료방법.방법 장본원714례출원진단급병리진단위이위임신적병례안림상특정、수술소견급병리결과분위사조:파렬휴극조、파렬조、유산휴극조、유산조,비교각조지간적정경시간、복통시간、무음도류혈、혈β-HCG수평、복강내출혈량이급혈홍단백수평륙항지표적차이정황.결과 본연구중각충류형이위임신적구성비의차위유산조57.14%(408/714)、파렬조27.17%(194/714)、파렬휴극조11.48%(82/714)、유산휴극조4.21%(30/714).기중이파렬휴극조정경시간최단,무음도류혈적발생솔최저,복통시간최단,혈β-HCG수평최고.유산조적정경시간최장,무음도류혈발생솔최저,혈β-HCG수평최저.복강내출혈량、혈홍단백강폭이급수혈(농축홍세포현액)량이유산휴극조최다.결론 정경시간단、복통시간단무음도류혈이급혈β-HCG수평고가피간위시파렬휴극형이위임신적예조,치료수급시,이유산휴극형유우출혈속도교만,환자축점내수,지휴극시복강내출량이비상대,통상수대량수혈방능규정휴극급개선빈혈.
Objective Discuss the early diagnosis and treatment of Shock in Ectopic Pregnancy.Methads According to the clinical features,operation findings and pathology result,divided 714 clients of ectopic pregnancy(diagnosed by discharge diagnosis and pathology diagnosis)to four groups:Ruptured Ectopic Pregnancy with shock,Ruptured Ectopic Pregnancy,Aborted Ectopic Pregnancy with Shock and Aborted Ectopic Pregnancy.Compared the difference of pregnancy time,duration of abdominal pain,vaginal bleeding,level of blood β-HCG,bleeding amount in peritoneal space and Hb level in 4 groups.ResultsIn this research,the percentage of each group respectively is:Aborted Ectopie Pregnancy 57.14% (408/714),Ruptured Ectopie Pregnancy 27.17% (194/714) ,Ruptured Ectopic Pregnancy with Shock 11.48% (82/714),Aborted Ectopic Pregnancy with Shock 4.21% (30/714).In the group of Ruptured Ectopic Pregnancy with Shock,the pregnancy time is shortest,the chance of no vaginal bleeding is lowest,duration of abdominal pain is shortest and the level of blood β-HCG is highest.In the group of Aborted Ectopic Pregnancy,the pregnancy time is longest,the chance of no vaginal bleeding is lowest and the level of blood β-HCG is lowest.As for the group of Aborted Eetopic Pregnancy with Shock,it has the highest result of bleeding amount in peritoneal space,decrease of Hb level and blood transfusion amount(packaged red blood cell).ConclusionShort pregnancy time,short duration of abdominal pain,no vaginal bleeding and high level of blood β-HCG could be viewed as the aura of Ruptured Ectopic Pregnancy with Shock,which needs quick and early treatment.For Aborted Ectopic Pregnancy with Shock,the bleeding is slown in small amount and the client usually can tolerate until the shock develops when the bleeding amount is significant.It usually needs large amount of blood transfusion to correct shock and anemia.