The Clinical Analysis Of 1886 Cases With Ectopic Pregnancy

Ectopic pregnancy is the most common acute abdomen of women of childbearing age. According to statistics, the incidence of 1-2%. Is the leading cause of death of pregnant women. Most of the ectopic pregnancy patients have obvious clinical symptoms, including: the history of menopause, vaginal bleeding, abdominal pain, syncope, accompanied by shock. Seriously affected the majority of women's lives and health.At present, the treatment of early ectopic pregnancy, the expectant and conservative medical treatment, the retention tube, to reduce injury, reduce costs, an irreplaceable position. For large mass, high blood HCG hemorrhagic shock associated with ectopic pregnancy, treatment is still surgical excision. Ectopic pregnancy surgery include: radical surgery and conservative surgery. Channel sub-abdominal surgery, transvaginal and laparoscopic and hysteroscopic surgery.Based on the clinical features of ectopic pregnancy were analyzed to explore the patient's age, etiology, mass growth area, mass size, the level of serum HCG and treatment options and prognosis, is intended to summarize the diagnosis and treatment of ectopic pregnancy.Methods: ectopic pregnancy in our hospital during the period 2009.1- 2010.1 clinical data reliability and integrity of those 1886 cases were reviewed, and the age distribution of ectopic pregnancy, etiology, clinical symptoms, diagnosis, treatment options, surgical procedure comparison, the prognosis of the application EXCEL software to build databases, application software, SPSS statistical analysis, count data using X2 test.Results: 1886 cases of ectopic pregnancy, age, mostly in women of childbearing age between 20-40 years of age accounted for 88.34%. Of which 1162 cases of 20-30 years old, unmarried fertility 41%. This information has typical clinical symptoms of 1257 cases of 66.7%. Among a total of 1498 cases of abdominal pain the most common accounting for 79.43%, 198 patients without typical symptoms accounted for 10.50%. Acute or chronic pelvic inflammatory disease accounts for 74.02% 1396 cases of ectopic pregnancy is one of the main. Preoperative ultrasound diagnosis rate 98.84%, 99.88% rate of preoperative diagnosis, misdiagnosis rate of 0.16%. Treatment based on surgery accounted for 85.95%. Surgical procedures, salpingectomy mainly accounted for a total of 1,050 cases of 55.67%. Operation in different ways in different age groups, younger conservative treatment and conservative surgery accounted for the greater proportion of 20 to-40 year-old conservative treatment and conservative surgical treatment of 697 cases accounted for 36.96% of this group of older choose the proportion of the more salpingectomy large,≥40 years of age choose salpingectomy 61.19% share of the group. Ectopic pregnancy in different parts of different surgical options. Fallopian tube isthmus and interstitial tubal pregnancy in order to account for the resection of the main group of 71.36%. Oviduct ampulla and fimbria pregnancy choose conservative surgery accounted for 36.11% of the group. Diameter<4cm group therapy or conservative surgery conservative large proportion of total 33.93%. Serum HCG value higher, the greater the proportion of surgical treatment options, and the higher the proportion of tubal surgery. Laparoscopy compared with laparotomy catheter removal after, the memory of blood and peritoneal bleeding volume, routine antibiotic prophylaxis; flatus, and abdominal incision suture removal after eating dates and wound healing situations such as the laparoscopic group were superior to open surgery group.Conclusion: 1. Ectopic pregnancy trends in incidence with age, and more in the 20-30 years old. 2. Ectopic pregnancy history of the major symptoms of menopause, abdominal pain, vaginal bleeding, abdominal mass, syncope, accompanied by shock. But a few patients with vaginal bleeding and menstrual confusion. Improving information and education on women of childbearing age, early detection, early treatment is to reduce the ectopic pregnancy Effective way of life threatened. 3. Ultrasonography and serum HCG is essential for diagnosis, after the dome puncture is an emergency situation the fastest and most accurate means of diagnosis of ectopic pregnancy, current ectopic pregnancy laparoscopy has become the principal diagnosis and treatment means. 4. In principle, ensure the vital signs were only under the premise of taking human nature, personalized treatment. Treatment of ectopic pregnancy were treated by operation, the choice of treatment depends largely on the patient's age, with or without fertility requirements, mass, size, level of serum HCG values. Salpingectomy is the treatment of ectopic pregnancy, the main surgical, minimally invasive surgery is the main method of treatment of ectopic pregnancy. 5. Ectopic pregnancy intrauterine pregnancy rate of long-term choice of treatment and no difference. Studies have shown that surgical treatment and conservative treatment of long-term intrauterine pregnancy are similar.