Ring D, Retzke U, Vollmar F
Frauenklinik, Bezirkskrankenhauses, Suhl.
Zentralbl Gynakol. 1989;111(8):507-15.
The diagnostic and therapeutic management in 80 cases with ectopic pregnancy is analysed. Only in 36 cases (45%) there was an accordance of installation diagnosis with the intraoperative status. 44 patients (55%) were suspicious to suffer from acute pelvic inflammatory disease, abortion or irregular uterine bleedings. Only in 28 cases (35%) the clinical symptomatology was so characteristic for ectopic pregnancy that operation had been performed without any other diagnostic procedures. In 34 cases (43%) a laparoscopy was necessary to get the correct diagnosis. In all the other 18 patients (22%) the indication for operation was made by punction of the cul-de-sac, curettage, and/or ultrasound. Because of an increased blood loss more than 500 ml an intra- or postoperative blood transfusion was necessary in about 1/3 of all treated patients. In 32% it was possible to preserve the fallopian tube. The corresponding operative procedure consisted of salpingotomy and manual expression of tubal pregnancy. Local vasoconstrictive acting substances are recommended. If there are hints at an ectopic pregnancy by histologic examination of tissue got by curettage quick and well-organized management is necessary to use the possibility of conservative operation-procedures. Histologic examination of all abortion tissue is requested.
对80例异位妊娠患者的诊断和治疗处理进行了分析。只有36例（45%）的初步诊断与术中情况相符。44例（55%）患者疑似患有急性盆腔炎、流产或子宫不规则出血。只有28例（35%）患者的临床症状对异位妊娠具有如此典型的特征，以至于在未进行任何其他诊断程序的情况下就进行了手术。在34例（43%）患者中，需要进行腹腔镜检查才能获得正确诊断。在所有其他18例患者（22%）中，通过后穹窿穿刺、刮宫和/或超声检查来确定手术指征。由于失血超过500毫升，约三分之一的所有接受治疗的患者在术中或术后需要输血。32%的患者有可能保留输卵管。相应的手术操作包括输卵管切开术和手动挤出输卵管妊娠物。建议使用局部血管收缩作用物质。如果刮宫获取的组织的组织学检查提示有异位妊娠，必须迅速且有条不紊地处理，以便利用保守手术操作的可能性。要求对所有流产组织进行组织学检查。
