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目的:探讨宫角妊娠的早期诊断和治疗方法。方法:回顾性分析2000年1月～2011年1月宁夏中医研究院56例经手术和病理证实的宫角妊娠患者的临床资料。结果:术前诊断宫角妊娠47例,误诊输卵管妊娠9例。超声、宫腔镜、腹腔镜检查用于早期诊断,诊断符合率分别为81.03%、100.00%、100.00%。56例均采用手术治疗,直接剖腹手术46例,其中宫角楔形切除加同侧输卵管切除术30例,宫角妊娠物剥除修补术6例;宫腔镜或腹腔镜手术21例,诊断为未破裂型宫角妊娠,其中宫腔镜下定位刮宫术9例,腹腔镜监视下刮宫术10例,腹腔镜下宫角局部注射氨甲蝶呤2例。宫腔镜、腹腔镜治疗成功率100.00%,达到剖腹手术效果。结论:宫角妊娠临床诊断困难,误诊率高。宫腔镜、腹腔镜早期诊断确切,微创治疗优势明显,值得临床推广。
Objective: To investigate the early diagnosis and treatment of uterine horn pregnancy. Methods: The clinical data of 56 patients with uterine horn pregnancy confirmed by operation and pathology from January 2000 to January 2011 in Ningxia Institute of Traditional Chinese Medicine were retrospectively analyzed. Results: Preoperative diagnosis of cornual pregnancy in 47 cases, misdiagnosed tubal pregnancy in 9 cases. Ultrasound, hysteroscopy, laparoscopy for early diagnosis, diagnostic accuracy rates were 81.03%, 100.00%, 100.00%. 56 cases were treated by surgery, direct laparotomy in 46 cases, including the wedge resection of the horn and the ipsilateral tubal resection in 30 cases, the Palace of pregnancy in the ablation and repair of 6 cases; hysteroscopy or laparoscopic surgery in 21 cases, diagnosed as Unruptured uterine horn pregnancy, including hysteroscopic positioning curettage in 9 cases, laparoscopic curettage in 10 cases, laparoscopic hormonal injection of methotrexate in 2 cases. Hysteroscopy, laparoscopic treatment success rate of 100.00%, to laparotomy effect. Conclusion: The clinical diagnosis of uterine horn pregnancy is difficult and the rate of misdiagnosis is high. Hysteroscopy, laparoscopy early diagnosis is accurate, minimally invasive treatment has obvious advantages, it is worth clinical promotion.