残角子宫妊娠6例临床分析

Clinical analysis of 6 cases of rudimentary horn pregnancy

目的探讨残角子宫妊娠的临床特征、诊断及处理。方法回顾性分析洛阳市妇女儿童医疗保健中心妇科自1998年6月-2010年12月收治的6例残角子宫妊娠临床资料。结果6例均行剖腹残角子宫切除及同侧输卵管切除。其中5例孕中期残角子宫自发破裂，大量腹腔内出血行急诊剖腹探查，术中确诊；只有1例为破裂前诊断。结论残角子宫妊娠是一种罕见的异位妊娠，有高度子宫破裂的危险，如不能及早发现、及早处理，会对母体造成极严重的后果。因此对可疑病例要高度警惕，超声检查对准确诊断、及时治疗、避免严重并发症非常重要。残角子宫和同侧输卵管切除是主要的处理方法。

Objective To investigate the clinical features, diagnostic criteria and treatment of rudimentary horn pregnancy （RI-IP）. Methods The clinical data of 6 cases of RHP treated in our hospital from January 1998 to December 2010 were respectively analyzed. Results Excision of the rudimentary horn and the ipsilateral faliopian tube were performed on 6 cases. Rudimentary horn ruptured during the second trimester in 5 cases, and emergent exploratory laparotomy were performed for mass intraabdominal hemorrhage and diagnosed in operation. Only 1 case was diagnosed before rupture. Conclusion RHP is a kind of rare form of ectopic gestation associated with high risk of uterine rupture. Serious consequences will occur to mother if not found and treated early. It is essential to maintain high alert on suspicious cases. Ultrasonographic examination is very important for accurate diagnosis, timely treatment and avoiding severe complications. Excision of rudimentary horn and ipsilateral fallopian tube is the primary management.