当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2015年
15期
45-45,46
,共2页
陈静华%陈永华%陈庆缇%程艳琳%沈红琼
陳靜華%陳永華%陳慶緹%程豔琳%瀋紅瓊
진정화%진영화%진경제%정염림%침홍경
残角子宫妊娠%诊断%手术治疗
殘角子宮妊娠%診斷%手術治療
잔각자궁임신%진단%수술치료
Rudimentary uterine horn pregnancy%Diagnosis%Surgery
目的：探讨残角子宫妊娠的临床特征、诊断及治疗，以期提高对该病的认知，减少误诊、漏诊和提高疗效。方法选取残角子宫妊娠患者11例，对其临床资料进行分析。结果术前正确诊断残角子宫妊娠2例（18.2%），误诊漏诊9例（81.8%），其中娠破裂伴失血休克行急诊手术6例。11例均手术行残角子宫切除及同侧输卵管切除，术后病理确诊为残角子宫妊娠。结论残角子宫妊娠是一种罕见的特殊部位异位妊娠，发病率极低，容易误诊和漏诊，多在妊娠中期破裂，一旦破裂可致失血性休克，危及生命。B超、MRI及腔镜检查对诊断有重要参考价值。残角子宫妊娠一旦诊断成立，应尽早手术切除残角子宫及同侧输卵管。术中不保留同侧输卵管，以免再次发生输卵管妊娠。对已破裂合并失血性休克者，在抗休克的同时行急诊行手术探查，对未破裂孕早期者行开腹探查手术或腹腔镜手术。
目的：探討殘角子宮妊娠的臨床特徵、診斷及治療，以期提高對該病的認知，減少誤診、漏診和提高療效。方法選取殘角子宮妊娠患者11例，對其臨床資料進行分析。結果術前正確診斷殘角子宮妊娠2例（18.2%），誤診漏診9例（81.8%），其中娠破裂伴失血休剋行急診手術6例。11例均手術行殘角子宮切除及同側輸卵管切除，術後病理確診為殘角子宮妊娠。結論殘角子宮妊娠是一種罕見的特殊部位異位妊娠，髮病率極低，容易誤診和漏診，多在妊娠中期破裂，一旦破裂可緻失血性休剋，危及生命。B超、MRI及腔鏡檢查對診斷有重要參攷價值。殘角子宮妊娠一旦診斷成立，應儘早手術切除殘角子宮及同側輸卵管。術中不保留同側輸卵管，以免再次髮生輸卵管妊娠。對已破裂閤併失血性休剋者，在抗休剋的同時行急診行手術探查，對未破裂孕早期者行開腹探查手術或腹腔鏡手術。
목적：탐토잔각자궁임신적림상특정、진단급치료，이기제고대해병적인지，감소오진、루진화제고료효。방법선취잔각자궁임신환자11례，대기림상자료진행분석。결과술전정학진단잔각자궁임신2례（18.2%），오진루진9례（81.8%），기중신파렬반실혈휴극행급진수술6례。11례균수술행잔각자궁절제급동측수란관절제，술후병리학진위잔각자궁임신。결론잔각자궁임신시일충한견적특수부위이위임신，발병솔겁저，용역오진화루진，다재임신중기파렬，일단파렬가치실혈성휴극，위급생명。B초、MRI급강경검사대진단유중요삼고개치。잔각자궁임신일단진단성립，응진조수술절제잔각자궁급동측수란관。술중불보류동측수란관，이면재차발생수란관임신。대이파렬합병실혈성휴극자，재항휴극적동시행급진행수술탐사，대미파렬잉조기자행개복탐사수술혹복강경수술。
Objective To investigate the clinical features, diagnostic and treatment of rudimentary uterine horn pregnancy, in order to improve the cognition of the disease, reduce misdiagnosis and enhance the curative effect.Methods The clinical date of 11 cases of rudimentary uterine horn pregnancy treated in our hospital from January 1998 to December 2012 were respectively analyzed, and with reference to the relevant literature on the disease to the analysis and summary.Results Preoperative diagnosis of 2 cases of rudimentary uterine horn pregnancy (18.2%), 9 cases were misdiagnosed (81.8%), including pregnancy rupture with hemorrhagic shock in 6 cases of emergency operation. All of the 11 cases of operation for rudimentary horn of uterus resection and ipsilateral salpingectomy. In all cases, the pathology examination conifrmed the diagnosis of rudimentary uterine horn pregnancy.Conclusion Rudimentary uterine horn pregnancy is a kind of special site ectopic rare pregnancy. The incidence rate is extremely low, easy to be ignored and lead to misdiagnosis or missed diagnosis. Mostly in mid pregnancy rupture, rupture can cause hemorrhagic shock, endanger life. Bultrasound, MRI and endoscopic examination has important reference value for the diagnosis. Once rudimentary uterine horn pregnancy diagnosis was established as early as possible and surgery rudimentary uterine horn ipsilateral fallopian tubes, Ipsilateral tubal surgery should not be retained in order to avoid the occurrence of tubal pregnancy again. For rudimentary uterine horn pregnancy has ruptured hemorrhagic shock, anti-shock, while undergoing emergency surgical exploration, For unruptured early pregnancy underwent laparotomy or laparoscopic surgery.
