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目的:进一步探讨异位妊娠误诊的原因及误诊药流后的表现特点,以提高对异位妊娠的认识及诊断水平。方法:对2008～2011年收治的8例异位妊娠因误诊宫内妊娠而行药物流产导致破裂出血者进行回顾性分析。结果:8例患者服用米索后多在2～5d出现腹痛或晕厥,阴道出血少,腹腔内出血在2000ml以上,很快进入休克状态。入院后抗休克、急诊行手术治愈,证实为输卵管妊娠。结论:异位妊娠是米索药流的禁忌症,误诊服药后常在短时间内发生大出血,给患者带来极大危害。因此,要加强对不典型异位妊娠的认识,注意结合病史、临床症状及辅助检查进行综合考虑,对超声检查结果注意分析,对自购药物行流产的危害加大宣教,同时加强基层卫生服务站的医疗设备建设及医务人员的培训,以提高诊疗水平。
Objective: To further explore the causes of misdiagnosis of ectopic pregnancy and the characteristics of misdiagnosed medical abdomen to improve the understanding and diagnosis of ectopic pregnancy. Methods: 8 cases of ectopic pregnancy admitted from 2008 to 2011 due to misdiagnosis of intrauterine pregnancy and medical abortion led to rupture of bleeding were retrospectively analyzed. Results: After taking misoprostol in 8 patients, abdominal pain or syncope occurred more than 2 ~ 5d, vaginal bleeding was less, intra-abdominal hemorrhage was over 2000ml, and quickly entered the state of shock. Anti-shock after admission, emergency surgery cured, confirmed as tubal pregnancy. Conclusion: Ectopic pregnancy is a contraindication to misoprostol. Hemorrhage often occurs in a short time after misdiagnosis, which brings great harm to patients. Therefore, to strengthen awareness of atypical ectopic pregnancy, pay attention to combined history, clinical symptoms and laboratory examinations to consider, the results of ultrasound examination analysis, the risk of miscarriage of self-medication drugs to increase education, and strengthen primary health services Station construction of medical equipment and medical personnel training to improve the level of diagnosis and treatment.