宫腹腔镜联合吸宫术治疗宫角妊娠的疗效分析

目的 讨论宫腹腔镜联合吸宫术在宫角妊娠治疗的临床价值.方法 回顾性分析本院妇产科2012年3月至2014年10月因宫角妊娠行宫腹腔镜联合吸宫术的22例患者的临床资料.结果 22例患者中9例宫腔粘连,3例不完全纵膈子宫,10例为口服药物流产失败.22例患者术中,2例吸宫时宫角穿孔;2例宫腔镜下电凝出血及刮除妊娠组织时宫角破裂,腹腔镜下随行宫角修补术,手术时间15 ～ 30min,平均(25±3) min,术中出血15 ～ 150 ml,平均(25±14) ml;宫角未穿孔及破裂患者18例,出血约10～20ml,平均(15±5) ml.术后2个月查β-HCG均恢复正常;术后28～35 d月经来潮;无1例中转开腹切除宫角和输卵管.结论 宫腹腔镜联合吸宫术是治疗宫角妊娠保留宫角和输卵管的一种安全有效的方法.

The curative effect analysis of hysteroscopy laparoscopy combined with uterine aspiration in the treatment of uterine horn pregnancy

Objective To investigate the clinical value of hysteroscopy laparoscopy combined with uterine aspiration in the treatment of uterine horn pregnancy.Method Clinical data of 22 cases of uterine horn pregnancy treated by hysteroscopy laparoscopy combined with uterine aspiration in department of obstetrics and gynecology of our hospital from March 2012 to October 2014 was retrospectively analyzed.Results In 22 cases,there were 9 cases of intrauterine adhesions,3 cases of incomplete longitudinal diaphragm.In 22 cases,there were 2 cases of perforation of the uterine horn caused by uterine aspiration,2 cases of rupture of the uterine horn caused by electric coagulation hemostasis and shaving the pregnancy tissue,accompanied by laparoscopic surgery,the operation time was 15-30 minutes,the average (25±3) minutes,the hemorrhage volume during operation was 15-150 ml,the average (25±14) ml.There were no perforation and rupture of the uterine horn in 18 cases,the hemorrhage volume was 10-20 ml,the average (15±5) ml.HCG level returned to normal 2 months after operation.Menstruation occurred 28-35 days after surgery.Conclusion Hysteroscopy laparoscopy combined with uterine aspiration is a safe and effective method of reserving uterine horn and fallopian tube in the treatment of uterine horn pregnancy.