罕见卵巢妊娠1例并相关文献复习

A Case Report of Rare Ovarian Pregnancy and Review of Related Literature

摘要: 目的：探讨卵巢妊娠(Ovarian Pregnancy, OP)的疾病特征、临床表现及诊疗方案。方法：回顾性分析青岛大学附属医院收治的一例孕11⁺⁵周OP患者的临床资料，结合复习相关文献并进行讨论。结果：该例患者术前行B超示子宫右侧见8.6 × 9.1 × 7.4 cm孕囊样回声，内见胎芽长约4.9 cm，见心管搏动。因孕周较大，术前未能明确诊断，入院后决定在全麻下行腹腔镜探查术，术中诊断OP，最终决定行经腹右侧卵巢输卵管切除术。术后病理符合妊娠，随访血清β-HCG降至正常，治疗成功。结论：OP临床罕见，B超等检查虽可协助诊断，但术前常难以诊断明确。OP患者尽早手术治疗可显著改善预后，避免盆腹腔内大出血等风险的发生。宜采用多种辅助检查联合协助诊断的方法，但早期对OP做出明确诊断仍是巨大挑战。

Abstract: Objective: To explore the disease characteristics, clinical manifestations, and diagnosis and treat-ment plans of ovarian pregnancy (OP). Method: A retrospective analysis was conducted on the clin-ical data of a patient with OP at 11⁺⁵ weeks of pregnancy admitted to the Affiliated Hospital of Qing-dao University. Relevant literature was reviewed and discussed. Result: The patient’s preoperative ultrasound showed 8.6 × 9.1 × 7.4 cm gestational sac like echo on the right side of the uterus, with fetal buds approximately 4.9 cm in length and pulsation of the cardiac canal. Due to the large gesta-tional age, a clear diagnosis was not made before surgery. After admission, it was decided to under-go laparoscopic exploration under general anesthesia, and OP was diagnosed during the surgery. Finally, it was decided to undergo transabdominal right ovarian salpingectomy. Postoperative pa-thology consistent with pregnancy, follow-up serum β-HCG decreased to normal and treatment was successful. Conclusion: OP is rare in clinical practice, and although B-ultrasound and other exami-nations can assist in diagnosis, preoperative diagnosis is often difficult to determine. Early surgical treatment for OP patients can significantly improve prognosis and avoid the occurrence of risks such as pelvic and abdominal bleeding. It is advisable to use a combination of multiple auxiliary examinations to assist in diagnosis, but making a clear diagnosis of OP in the early stage remains a huge challenge.