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异位妊娠 - 妇科 - CCUN护理网 - 中国第一护理门户网站

异位妊娠

异位妊娠,也称为子宫外孕、宫外孕。指受精卵在子宫腔以外的部位种植发育者。根据着床部位不同,有输卵管妊娠(约95%)、卵巢妊娠、腹腔妊娠、宫颈妊娠。在妊娠早期即可发生破裂,造成腹腔内出血、休克,是妇产科常见的急腹症之一。
  • 异位妊娠的临床表现

    输卵管妊娠的临床表现与受精着床部位、有无流产或子宫破裂、出血量多少以及时间长短等有关。
      1.停经  多数患者停经6-8周后出现不规则阴道流血,但有些因月经期仅过几天,误将不规则的阴道流血视为月经,也可能无停经主诉。
      2.腹痛  是输卵管妊娠患者就诊的主要症状。输卵管妊娠未发生流产或破裂前,常表现为一侧下腹隐痛或酸胀感。输卵管妊娠流产或破裂时,患者突然一侧下腹撕裂样疼痛。随后,血液由局部、下腹流向全腹,疼痛亦遍及全腹,放射至肩部;当血液积聚于直肠子宫陷凹处,可出现肛门坠胀感。
      3.阴道流血  胚胎死亡后,常有不规则阴道流血,色暗红或深褐量少,呈点滴状,一般不超过月经量。
      4.晕厥与休克  急性大量内出血及剧烈腹痛可引起晕厥或休克。
      5.腹部包块  当输卵管妊娠流产或破裂后形成的血肿时间过久,可因血液凝固,逐渐机化变硬并与周围器官发生粘连而形成包块。

  • 异位妊娠的临床护理

     1.见妇科一般护理。
      2.精神安慰和必要的解释宣传,使患者与医务人员配合。
      3.密切观察血压、脉搏、呼吸、面色、腹痛及阴道流血情况等,重视主诉,以便及时发现异常情况,报告医师。保持会阴清洁,必要时保留会阴垫,注意有无双层白色的蜕膜管型样组织物排出。
      4.患者应卧床休息,尽量减少突然改变体位或增加腹压的动作,从而减少异位妊娠破裂的机会。护士应告诉患者病情发展的一些指征,如出血增多、腹痛加剧、肛门坠胀感明显等,以便医患均能及时发现病情变化,给予相应处理。
      5.在保守治疗过程中,禁止用止痛剂及灌肠。
      6.做好阴道后穹窿穿刺和腹腔镜准备。
      7.休克患者应抗休克抢救,去枕平卧、定血型、配血、吸氧、建立静脉通路、补液,必要时输血,保暖,并做好术前护理工作。
      8.饮食指导,保守治疗期间,指导患者摄取足够的营养物质,尤其是富含铁蛋白的食物,如鱼肉、豆类、绿叶蔬菜及黑木耳等;忌进生、冷、油腻食物。

  • 异位妊娠的健康指导

      教育患者术后1个月禁性生活。保持良好的卫生习惯,勤洗浴、勤换衣,性伴侣稳定。发生盆腔炎后须立即彻底治疗,以免延误病情。下次妊娠时要及时就医,并且不宜轻易终止妊娠。

  • 异位妊娠的用药指导

  • 异位妊娠的保健品

  • 异位妊娠的相关资讯


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