残角子宫妊娠通过腹腔镜检查及治疗的临床分析

Rudimentary uterine horn pregnancy of the laparoscope surgery ： 4 cases report

目的：通过广东省第二人民医院收治的4例残角子宫妊娠病例通过腹腔检查及治疗的报道，探讨残角子宫妊娠的诊断和治疗现状。方法：对2007—2011我院收治的4例通过腹腔镜检查及治疗的残角子宫妊娠病例进行分析，并结合相关文献总结目前的诊断和治疗方法。结果：其中有2例患者因人流术后未见绒毛、并在B超监测下行清官术仍无法吸出孕囊，收入院，入院时均无明显临床症状。其中1例因不规则阴道流血、B超提示子宫肌瘤行腹腔镜检查及病理检查结果提示为残角子宫妊娠，其中另外1例患者因停经后反复阴道流血，行B超检查考虑为异位妊娠，行腹腔镜检查诊断为残角子宫妊娠。4例患者均行腹腔镜下妊娠的残角子宫切除，预后好。结论：残角子宫妊娠罕见，孕早期常无临床表现，但如延误治疗后果严重，早期诊断非常重要，B超及MRT检查有助于术前诊断，手术是最重要的治疗方式。

Objective：To study the current situation of diagnosis and treatment of rudimentary uterine horn pregnancy through 4-cases report. Methods We made a clinical study of 4 cases of rudimentary uterine horn pregnancy admitted to our hospital between 2007 and 2011. Results Two patients had been undergone artificial abortion before they were admitted to ourhospital. AII the patients were asymptomatic. Ultrasonography was made in 4 cases. Two cases were diagnosed as normal pregnancy, One case was diagnosed as ectopic pregnancy, One case was diagnosed as fibroid. Four patients were cured with surgery. Conclusions Rudimentary uterine horn pregnancy is rare and withatypical clinical manifestation in the first trimester. Although diagnosis before surgery is difficult, uhrasonography and MRI make a great role. Surgery is the most important therapeutic method.