精子外游致残余输卵管妊娠1例
【摘要】精子或孕卵游走。如术中患侧卵巢见排卵孔则考虑为精子游走致孕,如对侧卵巢见排卵孔则为孕卵游走致孕。该患者术中见输卵管峡部缺如,患侧卵巢见排卵孔,考虑精子游走导致残余输卵管妊娠。因临床罕见所以报告。
【关键词】精子外游;残余输卵管
The sperm wanders abroad sends the remaining tubal pregnancy 1 example
Mao Xuhua Zhang Xiuchan Liu Wei
【Abstract】The sperm or is pregnant the egg to walk randomly. If in the technique the trouble side ovary sees a row of micropyle to consider that walks randomly for the sperm sends is pregnant, if the opposite side ovary sees a row of micropyle to be pregnant the egg to walk randomly sends is pregnant. In this patient technique sees the oviduct canyon department to lack like, contracts the side ovary to see a row of micropyle, considered that the sperm walks randomly causes the remaining tubal pregnancy. Because clinical rare, therefore report.
【Key words】The sperm wanders abroad; Remaining oviduct
【中图分类号】R713.8【文献标识码】A【文章编号】1002-574X(2010)08-0225-01
患者29岁,因停经40天,下腹痛3小时于2010年7月5日入院。入院后妇科查体:宫颈光滑、着色,子宫体前位、略大、质软,右侧附件区扪及6×5cm软性包块,边界不清,轻压痛,左侧附件区未扪及异常。B超提示子宫前倾位,体积略大,子宫内膜厚约1.1cm,宫腔内未见孕囊样回声,右附件区见6.1×4.9cm包块,边界不清,形态不规整;左附件区未见明显异常;腹腔内液性暗区最深处3.2cm。提示:右附件区混合性包块(宫外孕可能性大)。化验血HCG2352mIU/ml。行阴道后穹窿穿刺抽出红色不凝血约8ml。患者6月前因“右侧输卵管峡部妊娠破裂”于我院行右侧输卵管峡部(即病灶部分)切除术,术后患者恢复顺利。
考虑异位妊娠破裂急症行剖腹探查术,术中见:腹腔内游离血及血凝块,子宫约50天妊娠大,规则、质软,右侧输卵管峡部缺如,壶腹部增粗约6×5cm,表面未见破裂口,伞端见活动性出血,右侧卵巢略大,见排卵孔,左侧卵巢及左输卵管未见异常。行右侧残余输卵管切除术,切开输卵管见绒毛。术后2天化验HCG406.8mIU/ml。术后病理:右侧输卵管妊娠。
讨论:残余输卵管妊娠是指前次异位妊娠做患侧输卵管切除手术时未做全输卵管切除,残留之部分输卵管再次发生妊娠。原因(一)输卵管再通。如异位妊娠输卵管部分切除术后断端再通。此原因较常见,与手术操作不规范可能有关。原因(二) 精子或孕卵游走。如术中患侧卵巢见排卵孔则考虑为精子游走致孕,如对侧卵巢见排卵孔则为孕卵游走致孕。该患者术中见输卵管峡部缺如,患侧卵巢见排卵孔,考虑精子游走导致残余输卵管妊娠。因临床罕见所以报告。, http://www.100md.com(毛旭华 张秀婵 刘伟)
【关键词】精子外游;残余输卵管
The sperm wanders abroad sends the remaining tubal pregnancy 1 example
Mao Xuhua Zhang Xiuchan Liu Wei
【Abstract】The sperm or is pregnant the egg to walk randomly. If in the technique the trouble side ovary sees a row of micropyle to consider that walks randomly for the sperm sends is pregnant, if the opposite side ovary sees a row of micropyle to be pregnant the egg to walk randomly sends is pregnant. In this patient technique sees the oviduct canyon department to lack like, contracts the side ovary to see a row of micropyle, considered that the sperm walks randomly causes the remaining tubal pregnancy. Because clinical rare, therefore report.
【Key words】The sperm wanders abroad; Remaining oviduct
【中图分类号】R713.8【文献标识码】A【文章编号】1002-574X(2010)08-0225-01
患者29岁,因停经40天,下腹痛3小时于2010年7月5日入院。入院后妇科查体:宫颈光滑、着色,子宫体前位、略大、质软,右侧附件区扪及6×5cm软性包块,边界不清,轻压痛,左侧附件区未扪及异常。B超提示子宫前倾位,体积略大,子宫内膜厚约1.1cm,宫腔内未见孕囊样回声,右附件区见6.1×4.9cm包块,边界不清,形态不规整;左附件区未见明显异常;腹腔内液性暗区最深处3.2cm。提示:右附件区混合性包块(宫外孕可能性大)。化验血HCG2352mIU/ml。行阴道后穹窿穿刺抽出红色不凝血约8ml。患者6月前因“右侧输卵管峡部妊娠破裂”于我院行右侧输卵管峡部(即病灶部分)切除术,术后患者恢复顺利。
考虑异位妊娠破裂急症行剖腹探查术,术中见:腹腔内游离血及血凝块,子宫约50天妊娠大,规则、质软,右侧输卵管峡部缺如,壶腹部增粗约6×5cm,表面未见破裂口,伞端见活动性出血,右侧卵巢略大,见排卵孔,左侧卵巢及左输卵管未见异常。行右侧残余输卵管切除术,切开输卵管见绒毛。术后2天化验HCG406.8mIU/ml。术后病理:右侧输卵管妊娠。
讨论:残余输卵管妊娠是指前次异位妊娠做患侧输卵管切除手术时未做全输卵管切除,残留之部分输卵管再次发生妊娠。原因(一)输卵管再通。如异位妊娠输卵管部分切除术后断端再通。此原因较常见,与手术操作不规范可能有关。原因(二) 精子或孕卵游走。如术中患侧卵巢见排卵孔则考虑为精子游走致孕,如对侧卵巢见排卵孔则为孕卵游走致孕。该患者术中见输卵管峡部缺如,患侧卵巢见排卵孔,考虑精子游走导致残余输卵管妊娠。因临床罕见所以报告。, http://www.100md.com(毛旭华 张秀婵 刘伟)
参见：首页 > 医疗版 > 疾病专题 > 妇产科 > 异常妊娠 > 输卵管妊娠(宫外孕)