13例妊娠期蜕膜脱垂诊治分析

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英文篇名：Diagnosis and Treatment of Decidua Prolapse During Pregnancy: a Report of 13 Cases 作者：赵荣 ; 林超琴 ; 张钧 ; 林海峰 英文作者：ZHAO Rong;LIN Chaoqin;ZHANG Jun;LIN Haifeng;Department of Gynaecology, Fujian Provincial Maternity and Children's Hospital; 关键词：蜕膜脱垂 ; 妊娠期 ; 症状 ; 诊断 ; 治疗 ; 自然流产 英文关键词：decidua prolapsed;;gestation period;;symptom;;diagnosis;;treatment;;spontaneous abortion 中文刊名：WSBZ 英文刊名：China Health Standard Management 机构：福建省妇幼保健院妇科; 出版日期：2019-03-15 出版单位：中国卫生标准管理 年：2019 期：v.10 语种：中文; 页：WSBZ201905015 页数：3 CN：05 ISSN：11-5908/R 分类号：51-53

摘要

目的探讨妊娠期蜕膜脱垂的诊断及临床治疗策略。方法收集2017年1月—2018年12月我院诊治的13例妊娠期蜕膜脱垂患者临床资料,进行回顾性分析。结果 13例患者中位年龄32岁,孕周6.7～14.0周;84.6%(11/13)有阴道出血症状。11例孕前妇检未见异常。行单纯宫颈赘生物摘除术7例;宫颈赘生物摘除+清宫术5例;行腹腔镜下患侧输卵管切除+宫颈赘生物摘除术1例。7例选择继续妊娠,术后2例自然流产,5例妊娠至足月分娩。结论蜕膜脱垂多见于妊娠早中期,常表现为阴道出血等症状。确诊需病理,超声及阴道镜检查可协助诊断。蜕膜脱垂可能引发流产或早产,对于存在阴道出血或感染者,建议手术治疗。多采用直视下息肉切除的方式,存在一定的自然流产率。
        Objective To explore the diagnosis and clinical treatment of decidua prolapse during pregnancy. Methods The clinical data of 13 patients with decidua prolapse during pregnancy from January 2017 to December 2018 were collected and analyzed retrospectively. Results The median age of 13 patients was 32 years old, the gestational age was 6.7 to 14.0 weeks, and 84.6%(11/13) had vaginal bleeding symptoms. No abnormalities were found in prenatal gynecological examination for 11 pregnant women. Cervical neoplasm removal was performed in 7 cases. 5 cases were treated with cervical vegetation excision and uterine curettage. 1 case underwent laparoscopic salpingectomy and cervical neoplasm removal.7 cases chose to continue pregnancy, 2 cases had spontaneous abortion after operation, and 5 cases had pregnancy to full-term delivery. Conclusion Decidua prolapse is more common in the second trimester of pregnancy,often manifested as vaginal bleeding and other symptoms. Diagnosis needs pathology, ultrasound and colposcopy can assist in diagnosis. Decidual prolapse may lead to abortion or premature delivery, for vaginal bleeding or infection, surgery is recommended. Polypectomy is more often used under the direct vision, there is a certain rate of spontaneous abortion.

引文

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