宫腔镜联合B超治疗宫角妊娠的效果研究

杨阳 李晓艳 陈丽

【摘要】 目的：分析宮腔镜联合B超治疗宫角妊娠的临床效果。方法：选取2014年1月-2018年12月笔者所在医院就诊的宫角妊娠患者103例，按照随机对照法将其分为对照组（n=50）及观察组（n=53），对照组采用常规清宫术及B超治疗，观察组采用宫腔镜联合清宫术及B超进行治疗，比较两组治疗效果。结果：观察组术后血β-hCG恢复正常时间、月经恢复正常时间均早于对照组，住院时间明显短于对照组，差异均有统计学意义（P<0.05）。两组手术时间比较，差异无统计学意义（P>0.05）。观察组术中出血量显著低于对照组，差异有统计学意义（P<0.05）。术后两组盆腔积液、β-hCG水平均显著低于术前（P<0.05），且观察组均显著低于对照组，差异有统计学意义（P<0.05）。两组并发症发生率比较，差异无统计学意义（P>0.05）。结论：利用宫腔镜联合清宫术及B超治疗宫角妊娠的临床效果较好，有助于促进患者的恢复。

【关键词】 宫腔镜 B超 宫角妊娠 异位妊娠

doi：10.14033/j.cnki.cfmr.2019.29.015 文献标识码 B 文章编号 1674-6805（2019）29-00-03

[Abstract] Objective： To analyze the clinical effect of hysteroscopy combined with B-mode ultrasound in the treatment of uterine horn pregnancy. Method： A total of 103 patients with uterine horn pregnancy who were admitted in our hospital from January 2014 to December 2018 were selected and divided into the control group （n=50） and the observation group （n=53） according to the randomized control method. The control group was treated with routine uterine curettage and B-mode ultrasound， while the observation group was treated with hysteroscopy combined with uterine curettage and B-mode ultrasound. The therapeutic effects of the two groups were compared. Result： The recovery time of blood β-hCG and menstruation in the observation group were earlier than those in the control group， and the length of hospital stay in the observation group was significantly shorter than that in the control group， the differences were statistically significant （P<0.05）. There was no significant difference in operation time between the two groups （P>0.05）. The intraoperative amount of bleeding in the observation group was significantly lower than that in the control group， and the difference was statistically significant （P<0.05）. The levels of pelvic effusion and β-hCG in the two groups after operation were significantly lower than those before operation （P<0.05）， and the observation group was significantly lower than the control group， the differences were statistically significant （P<0.05）. There was no significant difference in the incidence of complications between the two groups （P>0.05）. Conclusion： The clinical effect of hysteroscopy combined with hysterectomy and B-mode ultrasound in the treatment of uterine horn pregnancy is better， which is helpful to promote the recovery of patients.

[Key words] Hysteroscopy B-mode ultrasound Uterine horn pregnancy Ectopic pregnancy

First-authors address： Fujian Provincial Maternity and Childrens Hospital， Fuzhou 350001， China

宫角妊娠在临床上并不常见，其患者数量在妊娠群体总数中约占3%，属于特殊部位妊娠，主要是指受精卵在子宫角部“着床”、发育生长，且多向宫腔内侧生长。子宫角部存在血运丰富、肌层较厚等特点，一旦发生子宫破裂，很容易引起大出血，导致宫角破裂、出血性休克，增加死亡风险，威胁产妇生命安全[1-2]。因此，宫角妊娠早期明确诊断，有助于及时终止妊娠，挽救产妇生命。宫角妊娠治疗方案较多，比如子宫动脉栓塞+宫腔镜引导、血管介入治疗、宫角切除术等，均获得一定的治疗效果[3-4]。本次研究以2014年1月-2018年12月为研究时间段，以此期间在笔者所在医院就诊的宫角妊娠患者103例为研究对象，分析常规清宫术及B超、宫腔镜联合清宫+B超方案的治疗效果，现报告如下。……