双侧输卵管切除术后卵巢妊娠一例

doi:10.12280/gjszjk.20240403

摘要/Abstract

摘要：

报道1例辅助生殖技术中既往接受双侧输卵管切除术后右侧卵巢妊娠的病例。在胚胎移植第20天经阴道超声发现右侧卵巢内异位妊娠团块，及时行腹腔镜下右侧卵巢妊娠组织清除术并修复卵巢，术后人绒毛膜促性腺激素β亚单位（β-human chorionic gonadotropin，β-hCG）下降满意。分析本病例的诊疗经过、卵巢妊娠的危险因素和发生机制。卵巢妊娠可能是辅助生殖技术中接受双侧输卵管切除术后的意外并发症。对于辅助生殖技术中行双侧输卵管切除术的患者，特别是多胚胎移植的患者，通过β-hCG及经阴道超声检查能做到对卵巢妊娠的早诊断，以最大限度地保护患者的生育能力。

关键词: 生殖技术，辅助, 输卵管，切除, 妊娠，异位, 卵巢妊娠, 病例报告

Abstract:

A case of right ovarian pregnancy was reported. In this case, the patient with a history of bilateral salpingectomy underwent the treatment of assisted reproductive technology. On the 20th day of embryo transfer, an ectopic pregnancy mass in the right ovary was found by transvaginal ultrasound. The laparoscopic surgery was performed in time to remove the ovarian pregnancy tissue and to repair the ovary. The level of β-human chorionic gonadotropin (β-hCG) was decreased satisfactorily after surgery. The diagnosis and treatment process, risk factors and mechanism of ovarian pregnancy were analyzed. Ovarian pregnancy can be an unexpected complication after bilateral salpingectomy in assisted reproductive technology. For the patients undergone bilateral salpingectomy, especially in those patients with multiple embryo transfer, early diagnosis of ovarian pregnancy can be achieved through β-hCG and transvaginal ultrasound, so as to maximize the protection of patients′ fertility.

Key words: Reproductive technology, assisted, Fallopian tubes, excision, Pregnancy, ectopic, Ovarian pregnancy, Case reports

杨华菊, 周颖, 郑雪婷, 郑杰. 双侧输卵管切除术后卵巢妊娠一例[J]. 国际生殖健康/计划生育杂志, 2025, 44(1): 21-25.

YANG Hua-ju, ZHOU Ying, ZHENG Xue-ting, ZHENG Jie. Ovarian Pregnancy after Bilateral Salpingectomy: A Case Report[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(1): 21-25.

图/表 4

图1 2023年12月20日卵巢妊娠超声图注：右侧卵巢（right ovary，ROV），子宫（uterus，UT），Mass（M）为右侧卵巢内异位妊娠团块，其内见厚壁孕囊样结构。A 右侧卵巢矢状面。B 右侧卵巢横切面。

图2 2023年12月22日卵巢妊娠超声图注：右侧卵巢（right ovary，ROV），子宫（uterus，UT），Mass（M）为右侧卵巢内异位妊娠团块，其内见厚壁孕囊回声及卵黄囊回声。A 右侧卵巢矢状面。B 右侧卵巢横切面。

图3 右侧卵巢妊娠腹腔镜下图像注：A 箭头所指为右侧卵巢内见妊娠包块呈蓝紫色结节。B 箭头所指为切开后的绒毛样组织。

图4 卵巢妊娠患者术后病理图（HE染色×400）注：A 箭头所指宫腔组织呈高度分泌反应，间质蜕膜样变。B 箭头所指为右侧卵巢组织内绒毛。标尺=300 μm。

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