先兆流产合并子宫内血肿病例报告
Threatened Abortion combined with Intrauterine Hematoma Case Report
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1.广州中医药大学第一临床医学院,广州 510405
2.广州中医药大学第一附属医院妇科,广州 510405
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张惠敏, 朱玲, 罗颂平. 先兆流产合并子宫内血肿病例报告[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=33602290&Fpath=home&index=0
ZHANG Huimin, ZHU Ling, LUO Songping. Threatened Abortion combined with Intrauterine Hematoma Case Report[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=33602290&Fpath=home&index=0
张惠敏, 朱玲, 罗颂平. 先兆流产合并子宫内血肿病例报告[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=33602290&Fpath=home&index=0 DOI:
ZHANG Huimin, ZHU Ling, LUO Songping. Threatened Abortion combined with Intrauterine Hematoma Case Report[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=33602290&Fpath=home&index=0 DOI:
病史摘要,2,患者40岁,G2P0A1,既往因社会因素人流1次,首次因“停经11+周,反复阴道流血1月余”就诊,症见:暂无阴道流血,偶有下腹部隐痛、恶心呕吐,乳房胀痛,大便1~2日/次,质地稀溏,余无特殊不适。舌淡红,边有齿印,苔白,脉滑数。辅助检查:孕9周前彩超提示子宫肌壁间小肌瘤,胚胎发育未见异常。孕11周彩超提示宫腔内孕囊旁大片混合回声区(81 mm×52 mm),胎儿发育正常。中医诊断 胎动不安,脾肾不固、兼夹血瘀证。西医诊断 先兆流产、绒毛膜下血肿。干预措施 中药汤剂以补肾健脾、化瘀安胎为法,方以寿胎丸为主方,酌情配伍化瘀止血之品,使瘀血去则胎自安,同时配合安胎养血类膏方、炖服方。并嘱患者多卧床休息,定期复查彩超评估宫腔内液性暗区变化情况。疗效转归 经中医药治疗,患者阴道流血、下腹部隐痛等症状减轻,后续彩超提示宫内液性暗区面积进行性减小并于孕中期完全消失,最终足月顺产1女婴。
Summary of case history, The patient was 40 years old, G2P0A1, who had one abortion due to social factors. She first visited the clinic with "11+ weeks of menopause and recurrent vaginal bleeding for more than 1 month". Symptoms include: temporary absence of vaginal bleeding, occasional lower abdominal pain and nausea and vomiting, breast tenderness, 1-2 days/time stools with loose texture, and no other discomfort. The tongue was light red with tooth marks on the sides, white tongue coating, and a smooth and frequent pulse. Auxiliary examination: ultrasound before 9 weeks of pregnancy suggested small intermyometrial fibroids and no abnormal embryonic development. Ultrasound at 11 weeks of pregnancy showed a large liquid dark area (81 mm×52 mm) next to the gestational sac in the uterine cavity, and the fetus was developing normally.,TCM diagnosis ,Fetal irritability, Insufficiency of the spleen and kidney, with blood stasis.,Western medicine diagnosis, Threatened abortion, subchorionic hematoma.Therapeutic methods Chinese herbal soup was to tonify the kidney, strengthen the spleen, resolve blood stasis and calm the fetus. The formula was based on Shoutaiwan, and was combined with Chinese herbs to resolve blood stasis and stop bleeding as appropriate, so that the fetus would be settled when the blood stasis was removed. At the same time, the formula was combined with ointment and stewed formula to calm the fetus and nourish the blood. The patient was also advised to rest in bed and to review the ultrasound regularly to assess the changes of the liquid dark area in the uterine cavity.,Clinical outcomes ,The patient's symptoms such as vaginal bleeding and lower abdominal pain were relieved by TCM treatment, and the area of intrauterine fluid dark area decreased progressively and disappeared completely in the middle of pregnancy as indicated by follow-up ultrasound.
子宫内血肿绒毛膜下血肿先兆流产胎动不安罗颂平【适合阅读专业】 中医学妇科产科
Intrauterine hematomasubchorionic hematomathreatened abortionfetal irritabilityLUO Songping【Suitable majors】 Chinese medicinegynecologyobstetrics
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