超声技术在宫内并宫角部妊娠的诊断与治疗中的应用  

Application of ultrasonography in diagnosis and treatment of intrauterine pregnancy complicated with cornual pregnancy after in-vitro fertilization embryo transfer

作　　者：赵庆红[1] 石华[1] 张玉国[1] 胡佳琪[1] 杨菁[1] 

机构地区：[1]武汉大学人民医院妇产超声科,430060

出　　处：《中华全科医师杂志》2017年第11期890-893,共4页Chinese Journal of General Practitioners

摘　　要：对2012年7月至2015年8月就诊我院39例体外受精-胚胎移植（IVF-ET）后宫内并宫角部妊娠患者的临床资料进行回顾性分析.所有患者均为早期诊断宫内并宫角部妊娠,其中孕囊位置靠近输卵管间质部、宫角部向外突出明显、孕囊平均直径≥3.0 cm者29例（腹腔镜组）,孕囊位置偏向宫腔、孕囊或混合回声区平均直径〈3.0 cm者10例（减胎术组）.腹腔镜组行腹腔镜下宫角部楔形切除术,无中转开腹,术中出血少;减胎术组在超声监测下行经阴道抽吸减胎术.术后仅腹腔镜组1例于术后2周胚胎停育,余38例患者均稳定至足月分娩,无孕期腹痛及产后子宫破裂、大出血、胎盘残留等并发症.提示经阴道超声可早期诊断宫内妊娠合并宫角部妊娠,并为宫角部孕囊抽吸减胎术提供准确的术前评估和术中实时监测.The clinical data of 39 cases of intrauterine pregnancy complicated with cornual pregnancy after in-vitro fertilization embryo transfer （ IVF-ET） were analyzed retrospectively .All the patients were diagnosed by transvaginal ultrasound in early pregnancy , and the position of the gestational sac and its external process were determined by transvaginal ultrasound .According to the location and size of the gestational sac, the patients were divided into two groups： in group A （n=29） the gestational sac was located close to the interstitial tube and the gestational sac was larger , prominent out of the corners of the uterus;in group B （n=10） the gestational sac was located towards the uterine cavity , gestational sac was smaller and the embryo was not active .The laparoscopic angle wedge resection for group A and ultrasound-guided embryo reduction for group B were performed respectively .After treatment , 38 cases were stable to term delivery with intrauterine pregnancy; abortion occurred in 1 case of group A 2 weeks after operation . The early diagnosis and treatment is very important for intrauterine pregnancy complicated with cornual pregnancy . Ultrasonography provides an accurate preoperative assessment and intraoperative real -time monitoring during embryo reduction , which provides an alternative approach for the treatment of intrauterine pregnancy combined with cornual pregnancy .

关 键 词：超声检查 产前 三维 妊娠 异位 胚胎移植 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]