小剂量甲氨蝶呤治疗异位妊娠致外阴重度水肿一例
Chinese Journal of Obstetrics and Gynecology（2018）
Abstract
患者27岁,孕2产1,因"停经35 d,同房后腹痛8 h"于外院就诊,外院超声检查提示宫腔内未见妊娠囊,右侧附件包块4.5 cm×4.4 cm,不排除异位妊娠包块,盆腔积液5.3 cm×2.6 cm;血hCG为314 U/L;考虑"妊娠黄体破裂,不排除异位妊娠",遂于全身麻醉下行腹腔镜右侧卵巢黄体破裂修补+盆腔粘连松解+诊刮术;术后病理检查结果为:分泌期子宫内膜,间质蜕膜样变,右侧卵巢黄体囊肿破裂出血;复查血hCG为420 U/L,诊断为异位妊娠;后予甲氨蝶呤20 mg肌内注射,连续使用5 d.
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