经阴道超声诊断早期残角子宫妊娠1例

Transvaginal Ultrasonography Diagnosis of Early Residual Horn Pregnancy: A Case Report

目的:分析残角子宫妊娠的超声诊断及临床特征,为识别早期残角子宫妊娠的鉴别诊断及治疗提供临床思路。方法:分析我院1例G3P2,停经54天的残角子宫妊娠患者的诊治过程,并进行总结。结果:患者在全身麻醉下行腹腔镜残角子宫切除术 + 右侧输卵管切除术 + 左侧卵巢黄体囊肿剥除术 + 盆腔粘连松解术,手术顺利,患者术后生命体征良好。结论:残角子宫妊娠是一类罕见的异位妊娠,早期临床症状不典型,容易误诊及漏诊,极易引起残角子宫破裂及胎盘植入等致命并发症,临床一旦诊断应积极处理,剖腹手术或腹腔镜切除残角和同侧输卵管是处理残角子宫妊娠的主要方法。应了解并掌握残角子宫妊娠早期的超声及临床表现,以防止潜在的危及孕产妇生命的事件。

Objective: To analyze the ultrasonic diagnosis and clinical characteristics of residual horn pregnan-cy, and to provide clinical ideas for the differential diagnosis and treatment of early residual horn pregnancy. Methods: The diagnosis and treatment of G3P2 remnant horn pregnancy with 54 days of menopause in our hospital were analyzed and summarized. Results: The patient underwent lapa-roscopic residual horn hysterectomy + right salpingectomy + left ovarian luteal cyst stripping + pelvic adhesion release under general anesthesia. The operation was successful, and the patient’s postoperative vital signs were good. Conclusion: Residual angle of uterine pregnancy is a kind of ra-re ectopic pregnancy, early clinical symptoms is not typical, which is easy to cause misdiagnosis and missed diagnosis, and fatal complications such as uterine rupture of residual horn and placenta im-plantation. Once clinically diagnosed it should be actively handled. Laparotomy or laparoscopic re-section of residual horn and ipsilateral fallopian tube are the main methods to manage residual horn pregnancy. It is necessary to understand and master the ultrasound and clinical manifesta-tions of the remnant horn uterus in early gestation to prevent potential events threatening the life of pregnant women.