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1990年～1997年我院收治宫外孕89例,其中27例剖腹探查前因误诊为宫内孕而施人工流产术。为减轻患者痛苦,降低误诊率,提高计划生育工作质量。现对本组病例进行分析。1 临床资料1.1 误诊情况 本组27例中刮宫前诊断为正常宫内孕8例,先兆流产19例。其误诊单位为郊区卫生院和私人诊所13例,市级医院6例,省级医院2例。1.2 刮宫前主要症状 27例误诊者均有停经史,停经最短为35d,最长为80d,平均停经45d。13例有早孕反应（48.14％）;19例有少量阴道出血和轻度下腹痛（70.37％）;所有病例在行人工流产术前均无剧烈腹痛及昏厥病史。1.3 刮出物检查情况 14例未作检查,8例刮出物少,肉眼未见明显绒毛状组织。病理报告为间质呈蜕膜样变5例,其中4例经临床密切观察和B超检查,确诊为宫外孕.经保守治疗痊愈。19例在出现剧烈下腹痛伴内出血症状明显时,方确诊为宫外孕,8例于剖腹查时才诊断为宫外孕。1.4 刮宫后误诊情况 有人工流产术史,其后出现腹痛、昏厥等症状再次就诊。8例疑为感染、子宫穿孔、卵巢肿瘤等,经多次检查,辗转诊治,直到剖腹探查方获确诊。
From 1990 to 1997, 89 cases of ectopic pregnancy were treated in our hospital, 27 cases of which were misdiagnosed as intrauterine pregnancy and induced abortion. To alleviate the suffering of patients, reduce the rate of misdiagnosis and improve the quality of family planning work. Now the case analysis. 1 clinical data 1.1 misdiagnosis The group of 27 cases of curettage in the diagnosis of normal intrauterine pregnancy in 8 cases, threatened abortion in 19 cases. The misdiagnosed units were 13 suburban hospitals and private clinics, 6 municipal hospitals and 2 provincial hospitals. 1.2 The main symptoms before curettage 27 cases of misdiagnosis have menopause, shortest menopause 35d, the longest 80d, the average menopause 45d. 13 cases had early pregnancy reaction (48.14%); 19 cases had a small amount of vaginal bleeding and mild lower abdominal pain (70.37%); all cases had no history of severe abdominal pain and syncope before abortion. 1.3 Scratch inspection 14 cases were not examined, 8 cases less scraped material, the naked eye no significant villous tissue. The pathological findings were 5 cases of decidua degeneration in the stroma, of which 4 cases were diagnosed as ectopic pregnancy by clinical close observation and B-ultrasound, and were cured by conservative treatment. 19 cases of severe abdominal pain associated with internal bleeding symptoms were significantly diagnosed as ectopic pregnancy, 8 cases of Caesarean section was diagnosed as ectopic pregnancy. 1.4 curettage misdiagnosis of artificial abortion history, followed by abdominal pain, syncope and other symptoms again treatment. 8 cases of suspected infection, uterine perforation, ovarian cancer, after repeated inspections, removed after treatment until the laparotomy exploration side was diagnosed.