子宫肌壁间妊娠9例临床分析并文献复习  

Clinical analysis of 9 cases of intermural pregnancy and literature review

作　　者：屈清华[1] 林奕[1] 雷莉[1] 孙文洁[1] 胡晓吟[1] 徐冬梅[1] 潘赢政[1] 杨霞[1] 石岩[1] 郝丽娟[1] Qu Qinghua;Lin Yi;Lei Li;Sun Wenjie;Hu Xiaoyin;Xu Dongmei;Pan Yingzheng;Yang Xia;Shi Yan;Hao Lijuan(Department of Reproductive Endocrinology,Chongqing Health Center for Women and Children,Chongqing 401147,China)

机构地区：[1]重庆市妇幼保健院生殖内分泌科,401147

出　　处：《中华生殖与避孕杂志》2020年第9期761-766,共6页Chinese Journal of Reproduction and Contraception

基　　金：重庆市卫生局医学科研面上项目(2012-2-202)。

摘　　要：目的探讨子宫肌壁间妊娠的高危因素、早期诊断及治疗方法,提高肌壁间妊娠的临床诊治水平。方法回顾性分析2015年1月至2019年7月期间在重庆市妇幼保健院诊断为子宫肌壁间妊娠的9例临床资料,总结肌壁间妊娠的高危因素、临床表现、治疗结局。结果9例肌壁间妊娠患者中6例既往有人工流产术和宫腔、腹腔手术史,5例有胚胎移植术史。9例患者通过药物治疗、宫腹腔镜或经腹肌壁间妊娠物清除术后均保留了子宫完整性,1例早孕合并肌壁间复合妊娠的患者经腹腔镜治疗后妊娠得以继续。结论对具有高危因素患者应在妊娠早期就诊,提高对肌壁间妊娠的警惕性,宫腹腔镜联合探查术可快速明确诊断又可同时行微创手术,保留子宫完整性及生育能力,是治疗肌壁间妊娠的有效方法。Objective To analyze the high risk factors of intramural ectopic pregnancy,and to improve the clinical diagnosis and treatment of intramural ectopic pregnancy.Methods From January 2015 to July 2019,the clinical data of 9 patients with intramural pregnancy in Chongqing Maternal and Child Health Hospital were retrospectively analyzed.The high risk factors,clinical manifestations,treatment outcomes of intramural pregnancy were summarized.Results Nine patients with intramural pregnancy,6 cases had previous history of abortion,uterine or abdominal cavity surgery.Five cases had history of embryo transfer.The uterine integrity was preserved in 9 patients after treatment with medication,hysteroscopy,laparoscopy or transabdominal intramural pregnancy clearance.Pregnancy continued after laparoscopic treatment in a patient with early pregnancy complicated with intramural pregnancy.Conclusion Patients with high risk factors should be treated at the early stage of pregnancy.Hysteroscopy combined with laparoscopic exploration is an effective method for the treatment of intramural pregnancy,which can make a quick and definite diagnosis and perform minimally invasive surgery,and preserve uterine integrity and fertility.

关 键 词：子宫肌壁间妊娠 宫腔镜 腹腔镜 胚胎移植 

分 类 号：R714.22[医药卫生—妇产科学]