宫腹腔镜联合诊治宫角妊娠的探讨

Diagnosis and treatment of cornual pregnancy using laparoscope combined with hysteroscope

目的探讨宫腹腔镜联合诊治宫角妊娠的价值。方法回顾性总结2000年8月～2006年5月25例应用宫腹腔镜联合诊治宫角妊娠的情况。结果B超诊断宫角妊娠的25例患者,经宫腹腔镜联合检查确诊为宫角妊娠者12例,11例在宫腔镜下成功完成吸宫术,1例因子宫后倾后曲明显而操作失败,改为腹腔镜下宫角切除加子宫修补术,无1例发生子宫穿孔;间质部妊娠的7例,全部在腹腔镜下成功完成病灶切除;6例为宫内妊娠。结论B超对宫角妊娠的诊断具有较大的价值,但对鉴别宫角妊娠与间质部妊娠意义有限,宫腹腔镜联合不仅可明确诊断,同时可对此两种疾病进行微创治疗,减少患者的痛苦。

[Objective] To assess the effect of laparoscope combined with hysteroscope in the diagnosis and treatment of corneal pregnancy. [Methods] 25 cases of ＂cornual pregnancy＂ from August 2000 to May 2006 were diagnosed and treated with laparoscope and hysteroscope. [Result] In 25 cases of ultrasound diagnosed ＂cornual pregnancy＂, 12 cases of cornual pregnancy got the definite diagnosis by the combination of uteroscope and laparoscope, uterine aspiration succeeded with uteroscope in 11 cases, 1 case underwent laparoscopic treatment because of excess crooked of uterine; 7 cases of interstitial pregnancy of oviduct were diagnosed and treated under laparoscope; 6 cases of uterine pregnancy were diagnosed in hysteroscopy. [Conclusion] Cornual pregnancy can be diagnosed but not be exactly diagnosed by ultrasound. Cornual pregnancy and interstitial pregnancy of oviduct can be exactly diagnosed and treated by laparoscope combined with hysteroscope. The patients will get Mini-trauma and few distress.