圆韧带位置和宫腹腔镜检查在诊断输卵管间质部妊娠的价值研究

The Value of the Round Ligament Position in Laparoscopy Combined with Hysteroscopy in Diagnosis of Interstitial Pregnancy

目的：探讨圆韧带位置与宫腹腔镜检查在输卵管间质部妊娠的诊断价值。方法：选取2008年1月至2012年5月间我院拟诊的输卵管间质部妊娠50例，常规行宫腹腔镜联合检查，术中实时录像，从各个方位拍摄子宫圆韧带与宫角包块的关系，并总结分析。结果：50例均经宫腹腔镜检查确诊为输卵管间质部妊娠。50例患者圆韧带位于宫角包块内侧的占82．0％（41／50），包块中间的占8．0％（4／50），包块外侧的占10．O％（5／50）。50例患者输卵管间质部妊娠宫角包块直径1～8cm，按包块直径分为A组（包块直径〈4cm）22例和B组（包块直径≥4cm）28例，圆韧带位于宫角包块内侧的比例A组、B组分别为90．9％（20／22），75．0％（21／28），两组间差异有统计学意义（P〈0．05）。结论：以圆韧带位于宫角包块内侧诊断输卵管间质部妊娠不完全准确，不能作为诊断的标准。宫腹腔镜联合检查是诊断输卵管间质部妊娠的金标准。

Objective：The purpose of the study is to explore the value of the round ligament position and laparoscopy combined with hysteroscopy in distinguishing interstitial Pregnancy with uterus cornal pregnancy. Methods.50 patients who were diagnosed as interstitial pregnancy and underwent surgical treatment in our hospital from January 2008 to May 2012 were enrolled in the study. All patients underwent laparoscopy com- bined with hysteroscopy. The position of round ligament and the mass were recorded. Results.The positions of round ligament to the ectopic pregnancy lesion in 50 cases of interstitial pregnancy were as follows=inside to the lesion （82.0%,41/50）, medial to the lesion （8.0%, 4/50 ） and outside to the lesion （ 10. 0%, 5/50 ）. The diameter of the ectopic pregnancy lesion ranged from 1 to 8 cm. All cases were divided into 2 groups accordingto the diameter of lesion as group A（ less than 4 cm） and group B（ over 4 cm）. The ratio of the round liga- ment position which is inside to the lesion was 90.9%（20/22）and 75.0% （21/28）in two groups, respective- ly,of which the differencewas statistical significant. Conclusions：the position of round ligament inside to the ectopic pregnancy lesion can＇ t be diagnosis criteria of interstitial pregnancy. Laparoscopy combined with hys- teroscopy can be golden standard for distinguishing interstitial pregnancy with uterus cornal pregnancy.