腹膜后异位妊娠1例并文献复习

Retroperitoneal Ectopic Pregnancy: A Case Report and Literature Review

摘要: 受精卵在子宫体腔以外的其它地方着床称为异位妊娠(ectopic pregnancy, EP)，属于病理妊娠，是妊娠前3个月孕妇死亡的主要原因，而腹膜后异位妊娠(retroperitoneal ectopic pregnancy, REP)是异位妊娠的特殊类型，腹膜后异位妊娠十分罕见，发生率很低，发病机制尚且不明确，且目前无明确统一的诊疗方案。因其位置相对特殊：靠近大血管，故超声检查不易探查，这为临床诊断增加了难度，容易误诊、漏诊。因此对于不能明确的肿块位置应该扩大超声探查范围，并由高年资有经验的超声医生进行检查，或行CT以及MRI检查，必要时行多学科协作(MDT)，充分进行术前评估，保障病人生命安全。治疗方案目前多考虑手术治疗，对术者要求较高，术者应充分了解女性生殖系统解剖关系及其与周围大血管之间的关系，这样才能避免不必要的损伤进而成功救治该疾病。

Abstract: The implantation of fertilized eggs in other places other than the body cavity of the uterus is called ectopic pregnancy, which belongs to pathological pregnancy and is the main cause of maternal death in the first 3 months of pregnancy, and retroperitoneal ectopic pregnancy is a special type of ectopic pregnancy. Retroperitoneal ectopic pregnancy is very rare, the incidence is very low, the pathogenesis is not clear, and there is no clear and unified diagnosis and treatment plan. Due to its relatively special location: close to the great blood vessels, it is not easy to detect by ultrasound, which increases the difficulty of clinical diagnosis, easy to miss diagnosis and misdiagnosis. There-fore, if the location of the mass is not clear, the scope of ultrasound exploration should be expanded, and the examination should be carried out by senior and experienced sonographers, or CT and magnetic resonance examination should be performed. When necessary, multidisciplinary cooper-ation should be carried out to fully carry out preoperative evaluation, so as to ensure the patient’s life safety. Surgical treatment is often considered in the treatment plan, which is highly demanding for the surgeon. The surgeon should fully understand the anatomical relationship of the female re-productive system and its relationship with the surrounding great vessels, so as to avoid unneces-sary injury and successfully treat the disease.