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输卵管妊娠葡萄胎合并腹腔内出血一例

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输卵管妊娠葡萄胎在临床上极为罕见,术前诊断大多存在困难,确诊主要依靠术后组织病理学诊断。报告1例38岁女性因右侧输卵管妊娠破裂致腹腔内出血急诊行腹腔镜右侧输卵管切除术,术后病理提示完全性葡萄胎的病例。该患者术后恢复良好,随访期间血清人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)下降满意,无阴道出血、咳嗽和咳血等相关病灶转移症状。输卵管妊娠葡萄胎多表现为急腹症,因此对于急腹症患者临床上应警惕葡萄胎的可能性,其治疗多以手术为主,必要时行化疗,术后需严密随访,注意病变侵蚀及恶变可能。
A Case of Tubal Ectopic Pregnancy with Hydatidiform Mole and Intraperitoneal Hemorrhage
Tubal ectopic pregnancy with hydatidiform mole is extremely rare in clinical practice,and preoperative diagnosis is often difficult.The diagnosis is mainly based on the postoperative histopathology results.This article reports a 38-year-old woman whom underwent laparoscopic right fallopian tube resection in an emergency due to rupture of right fallopian tube pregnancy.The postoperative pathology revealed completeness hydatidiform mole.The patient recovered well after surgery,with a satisfactory decrease in serum human chorionic gonadotropin(hCG)during the follow-up period.There were no symptoms of vaginal bleeding,coughing,hemoptysis,or related lesion metastasis.Tubal pregnancy with hydatidiform mole often manifests as acute abdominal disease.Therefore,for patients with acute abdominal disease,the possibility of hydatidiform mole should be paid to.The treatment is mainly based on surgery,and chemotherapy should be performed if necessary.After surgery,close follow-up is required,and doctors should be noting the possibility of lesion erosion and malignancy too.

Pregnancy,tubalPregnancy,ectopicHydatidiform moleAbdominal cavityHemorrhage

张佟、叶红

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100026 首都医科大学附属北京妇产医院/北京妇幼保健院妇科微创中心

妊娠,输卵管 妊娠,异位 葡萄胎 腹腔 出血

2024

国际生殖健康/计划生育杂志
天津市医学科学技术信息研究所

国际生殖健康/计划生育杂志

CSTPCD
影响因子:0.694
ISSN:1674-1889
年,卷(期):2024.43(1)
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