腹腔镜手术保守治疗宫角妊娠临床分析  

Conservative laparoscopic management of cornual pregnancy

作　　者：韩肖燕[1] 冯凤芝[1] 万希润[1] 向阳[1] 

机构地区：[1]中国医学科学院,中国协和医科大学,北京协和医院妇产科,北京100730

出　　处：《生殖医学杂志》2009年第1期11-13,共3页Journal of Reproductive Medicine

摘　　要：目的探讨腹腔镜手术保守治疗宫角妊娠的效果及预后。方法回顾性分析因宫角妊娠行腹腔镜手术保守治疗10例患者的临床病理资料,并进行随访。结果 10例患者手术均顺利,无一例转行开腹,平均手术时间53. 5 min (40～75 min),平均失血量128 ml(50～400 ml),无一例输血,平均住院3.7 d(3～6 d)。患者术后血β-hCG 4周内均降至正常,术后30～60 d月经正常复潮,复查B超子宫肌层回声尚均。随访所有患者无任何并发症发生,1例术后1^+年再次妊娠,现妊娠3月一切正常。结论腹腔镜下保守治疗宫角妊娠是一种安全有效、微创且可行的方法,能很好地保留患者的生育功能,在有条件的医院,合理选择病例,对于血流动力学稳定,未破裂的宫角妊娠患者可积极开展此项手术。Objective.To investigate the efficacy and prognosis of conservative laparoscopic treatment of cornual pregnancy. Methods： We retrospectively analyzed the clinical and pathological data of 10 cases of cornual pregnancies that received conservative laparoscopic management in PUMC hospital from 2005 to 2007. Results： The average blood loss during surgery was 128 ml （range, 50-400 ml）, and average hospital stay was 3.7 days （range, 3-6 days）. No complication occurred and no blood transfusion was needed. All patients＇ uteri were successfully preserved. After operation, serum β-hCG levels declined to a normal limit within 4 weeks, and menstruation recovered within 2 months. One patient got pregnant one year later, and nothing abnormal had been found in the first trimester. Conclusion. Conservative laparoscopic treatment could be a safe, effective and micro-invasive alternative for the management of cornual pregnancy. The prognosis is good, and the patient＇s fertility can be preserved. So it deserves to be promoted in some well-conditioned hospitals for those unruptured cornual pregnancies with maternal hemodynamic stability.

关 键 词：宫角妊娠 异位妊娠 腹腔镜手术 保守治疗 

分 类 号：R714.22[医药卫生—妇产科学] R714.224[医药卫生—临床医学]