异位妊娠

Hydrosalpinx is detrimental to the outcome of IVF-ET and may cause the increase of abortion,appropriate procedure should be adopted to deal with the problem before the IVF-ET and may improve the outcome of IVF-ET and may decrease the abortion rate.Compared with the salpingectomy,the proximal tubal ligation with distal tubal salingostomy may be a better option in this situation and it may cause less interference to the ovarian function.

输卵管积水对IVF-ET有不良影响，增加了流产率及异位妊娠率，在IVF-ET前对输卵管积水进行适当的处理有助于提高临床妊娠率，降低流产率；与输卵管切除术相比，输卵管近端结扎伞端造口术对卵巢功能影响较小，不增加流产率及异位妊娠率。

Ninety-one cases of repeat ectopic pregnancy were demonstrated from 1380 cases of ectopic pregnancy.result: the repeat ectopic pregnancy was 6.59%(91/1380) after operation, eighty-four cases demonstrated as tubal pregnancy, six cases were tubal pregnancy three times, seven cases were cured by conservative medication,the recurrence of repeat ectopic pregnancy of twice was 86.81%(79/91). after salpingectomy of the patients who occurred the another tubal pregnancy was 90.41%.

结果：1380例异位妊娠发生重复异位妊娠91例（占6.59%），84例经手术探查证实为输卵管妊娠， 6例为输卵管妊娠3次，7例为药物保守治疗治愈，86.81%重复异位妊娠为连续两次异位妊娠。90.41%输卵管切除者的重复异位妊娠发生在对侧，而保守治疗者72.22%发生在原患侧，两者有显著性差异（p.001）。

Result :Up to 50% of women with ectopic pregany have had Chronic salpingitis previously.Early diagnosis of unruptured tube pregnancy will obviate later hemorrhagic shock..

结果50%异位妊娠女性存在慢性输卵管炎，异位妊娠的早期诊断有助于降低异位妊娠合并失血性休克的发生率。

The fastigium age has advanced about ten years comparing with the ten years befor, and in the clinic symptom, the bellyache rate is the highest; the genesic rate for menopause is similar to vagina blood, the degree and the characteristic of bellyache is related to the gestation rent; The blood amount relates both the gestation rent and the length from the fracture or abortion to cure; dated unusual gravidity is the tubbing bump for the characteristic of soft, faint boundary and ache et al; The electropositive rate for back cove centesis in vagina and colorful B ultrasonic diagnoses is higher than other testing method.

异位妊娠的发病高峰年龄较10年前提前了10年；临床症状中，腹痛发生率最高，停经与阴道流血发生率相似，腹痛的程度和性质与妊娠破裂部位有关；出血量除与妊娠破裂部位有关外，还与破裂或流产至就诊时间的长短有关；陈旧性异位妊娠多有以软、边界不清、触痛、拒按为特点的盆腔包块；阴道后穹窿穿刺、彩色B超诊断阳性率高于其他检测手段。

The results indicate that the disease occurred at the age of 30 -39 in the group of ectopic pregnancy cases(55. 9%), Ectopic pregnancy cases with a contraceptive device accounted to 30. 5%;and,the early symptoms of ectopic pregnancy are abdominal pains and colporrhagia that leads to fierce abdominal pains.

结果表明：本组异位妊娠发病年龄30～39岁占55.9％；带器异位妊娠占30.5％；异位妊娠初发症状腹痛、阴道出血距因剧烈腹痛、大量失血急诊入院平均时间分别为4.68天和9.60天，半数以上达到或超过3天。

Methods: The clinical data of 41 patints with rare ectopic pregnancy including interstitial pregnancy.23 cornual uterogestation,9 ovarian pregnancy,4 abdominal,2 pregnancy were retrospectively analyzed,deformity uterogestation,1 intramural pregnancy,1 and nub of fallopian tube pregnancy,were retrospectively analyzed.

回顾 分析 2003年7月至2005年10月经腹腔镜手术治疗的特殊部位异位妊娠41例的临床资料，包括输卵管间质部妊娠23例，宫角妊娠9例，卵巢妊娠4例，腹腔妊娠2例，残角子宫妊娠1例，子宫肌壁间妊娠1例，输卵管残端妊娠1例。

Results:Oviduct deoppilation rate of 40 patients with hight mark,36 patients with middle mark and 20 patients with low mark after laparoscopic surgery was 92.5%,87.5% and 77.5% respectively.Pregnancy rate of three group was 72.5%,30.6% and 0.Ectopic pregnancy rate of three group was 2.5%,8.3% and 10%.

结果：96例患者中高评分组40例，中评分组36例，低评分组20例，术后输卵管通畅率分别为92.5%、87.5%和77.5%，一年内宫内妊娠40例，三组妊娠率分别为72.5%、30.6%和0，异位妊娠6例，三组异位妊娠率分别为2.5%、8.3%和10%。

Results Out of the 48 cases,23 had been misdiagnosed as early entopic pregnancy;3,as threatened abortion;2,as pelvic inflammation;2,as endometritis; 1,as rupture of corpus luteum and torsion of ovarian cyst each;6,as acute appendicitis;1,as cholecystitis and 9,as acute gastroenteritis.

目的 探讨异位妊娠误诊的原因，提高异位妊娠早期诊断方法对1989年1月～2004年11月在我院收治的异位妊娠178例中48例异位妊娠误诊做回顾性分析，寻找导致误诊的因素。

The lower pregnancy rate was found in Group C,the highest abortion rate and ectopic pregnancy rate were found in Group C was 21.15% and 7.69% repectively,and was statistially different from that in control group (P.05).Conclusion Hydrosalpinx is detrimental to the outcome of IVF-ET and may cause the increase of abortion,appropriate procedure should be adopted to deal with the problem before the IVF-ET and may improve the outcome of IVF-ET and may decrease the abortion rate.

输卵管积水对IVF-ET有不良影响，增加了流产率及异位妊娠率，在IVF-ET前对输卵管积水进行适当的处理有助于提高临床妊娠率，降低流产率；与输卵管切除术相比，输卵管近端结扎伞端造口术对卵巢功能影响较小，不增加流产率及异位妊娠率。

objective to evaluate the clinical value of early diagnosis and therapy of suspicious ectopic pregnancy by laparoscopy.methods the clinical data of 53 suspicious tubal pregnancy patients were analyzed retrospectively,who had received laparoscopic operation in our hospital from january 2003 to december 2005.results all cases received laparoscopic operation,none was transferred to traditional surgery during the operation.46 cases were diagnosed as tubal pregnancy during the operation with pathologic proof.preoperative diagnosis rate was 86.8%.the salpingecstomy were performed in the 32 cases.the salpingotomy were performed in the 7 cases.conclusion the laparoscopic operation is the best choice in the early diagnosis and therapy of suspicious ectopic pregnancy,and it gain time for conservative therapy.but not too early.

目的 评价可疑异位妊娠患者腹腔镜早期诊治的临床价值。方法收集2003年1月～2005年12月收治的经腹腔镜手术治疗的可疑输卵管妊娠患者53例资料进行回顾性分析。结果 53例手术均经腹腔镜完成，无1例中转，术中诊断输卵管妊娠的46例，术前诊断率86.8%，32例行输卵管切除术，7例行保守性手术。结论腹腔镜手术是早期确诊可疑异位妊娠患者的最佳选择，也为保守性治理赢得时间，但不宜操之过急。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。