宫腔镜联合B超诊治宫颈妊娠

Clinical analysis of cervical pregnancy diagnosed and treated by hysteroscopy combined with B type ultrasound

目的:探讨宫腔镜联合B超在定位诊断和治疗宫颈妊娠中的作用。方法:应用宫腔镜技术联合B超检查对2007年12月～2008年11月收治的5例宫颈妊娠患者进行定位诊断;经米非司酮、甲氨蝶呤等药物辅助治疗后,在B超监护下行宫腔镜手术治疗。结果:5例患者宫腔镜联合B超的诊断结果与病理检查结果一致,均为胎盘绒毛及其机化、坏死组织;所有患者均一次性清除宫颈胚物,术后异常阴道流血停止,月经恢复正常;术后1个月查尿HCG阴性,血HCG正常,避免了全子宫切除。结论:宫腔镜联合超声检查能准确、直观地对宫颈妊娠残留物进行定位与定性,并能准确、完整地取出残留胚物,可作为宫颈妊娠的首选诊治方法。

Objective： To explore the value of hysteroscopy combined with B type ultrasound in topical diagnosis and curative efficacy for the patients with cervical pregnancy. Methods： 5 patients were diagnosed as cervical pregnancy by hysteroscopy combined with B type ultrasound from December 2007 to November 2008 ; after adjunctive therapy of mifepristone and methotrexate, then the patients underwent hysteroscopic operation under B type ultrasound monitoring. Results ： The diagnostic results of hysteroseopy combined with B type ultrasound was consistent with pathological results of 5 cases, which were placental villi and necrotic tissues. The cervical pregnancy tissues were taken out completely under hysteroscopy combined with B type ultrasound monitoring in all the cases. After operation, the abnormal vaginal bleeding in all cases stopped, menstruation recovery, the urine HCG darkened, the blood serum HCG decreased, avoiding hysterectomia. Conclusion： Hysteroscopy combined B type ultrasound can orient the position directly and confirm for the cervical pregnancy accurately, and take out them completely, which is of choice for diagnosis and treatment of the patients with cervical pregnancy.