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目的分析并总结异位妊娠并发失血性休克患者围手术期的有效救治方法。方法回顾性分析我院自2009年12月至2011年12月期间收治的67例异位妊娠并发失血性休克患者的临床资料。结果有人工流产史者占85.1%(57/67),引产史者占39.8%(20/67),剖宫产史者占8.9%(6/67),重复异位妊娠者占8.9%(6/67),盆腔炎病史68.7%(46/67),慢性宫颈炎病史者占76.1%(51/67)。37例(55.2%)输卵管峡部妊娠,22例(32.8%)壶腹部妊娠,实施患侧输卵管切除术;7例(10.4%)为间质部妊娠,实施患侧子宫角楔形切除与患侧输卵管切除术;1例(1.5%)卵巢妊娠实施患侧卵巢楔形切除术。本组未见死亡病例,在出院前患者血红蛋白均在73～104g/L范围内。结论医生与患者之间密切配合以进行早期异位妊娠诊断,能够有效预防异位妊娠并发失血性休克的发生。在围手术期开展液体复苏方案需要关注患者的个体化特点,并给予灵活处理。
Objective To analyze and summarize the effective methods of perioperative treatment of patients with hemorrhagic shock with ectopic pregnancy. Methods The clinical data of 67 patients with hemorrhagic shock with ectopic pregnancy admitted to our hospital from December 2009 to December 2011 were retrospectively analyzed. Results There were 85.1% (57/67) of abortion history, 39.8% (20/67) of history of induced abortion, 8.9% (6/67) of history of cesarean section, 8.9% of repeat ectopic pregnancy 6/67), history of pelvic inflammatory disease 68.7% (46/67), history of chronic cervicitis accounted for 76.1% (51/67). 37 cases (55.2%) of tubal isthmus pregnancy, 22 cases (32.8%) ampullary pregnancy, the implementation of ipsilateral tubal resection; 7 cases (10.4%) were interstitial pregnancy, the implementation of ipsilateral wedge resection of the horn and ipsilateral tubal One case (1.5%) of ovary pregnancy performed ipsilateral ovarian wedge resection. No deaths were observed in this group, with hemoglobin in the range of 73-104 g / L before discharge. Conclusion Close cooperation between doctors and patients for the diagnosis of early ectopic pregnancy can effectively prevent the occurrence of hemorrhagic shock in ectopic pregnancy. Perioperative liquid recovery programs need to focus on individual characteristics of patients and give flexibility.