谢素梅

【摘要】 目的：探究宫腔镜手术治疗宫角妊娠的临床可行性。方法：回顾性分析2016年7月-2018年7月本院收治的宫角妊娠患者临床资料，其中行常规腹腔镜切除或B超吸宫术患者50例为对照组，行宫腔镜手术患者50例为观察组。比较两组手术时间、术中出血量、住院时间及费用，以及术后患者阴道流血时间、hCG下降至正常的时间、宫内残留情况及子宫复旧情况。结果：观察组手术时间、术中出血量、住院时间、住院费用均少于对照组，差异均有统计学意义（P<0.05）;观察组术后阴道流血时间、hCG下降至正常时间均短于对照组，宫内残留及子宫复旧情况均优于对照组，差异均有统计学意义（P<0.05）。

结论：临床上宫腔镜手术治疗宫角妊娠具有微创、安全、有效、价格低廉等优势，可行性较高。

【关键词】 宫腔镜; 宫角妊娠; 常规手术; 可行性

【Abstract】 Objective：To explore the clinical feasibility of hysteroscopy in treatment of cornual pregnancy.Method：The clinical data of cornual pregnancy patients admitted to our hospital from July 2016 to July 2018 were retrospectively analyzed，50 patients who underwent conventional laparoscopic excision or B-mode ultrasonography were in control group and 50 patients who underwent hysteroscopy were in observation group.The operation time，intraoperative bleeding volume，hospitalization time and cost were compared between two groups，the time of vaginal bleeding，the time of hCG descending to normal，intrauterine residual and uterine involution between two groups were compared.Result：The operation time，intraoperative bleeding volume，hospitalization time and cost of observation group were less than those of control group，the differences were statistically significant（P<0.05）.The time of vaginal bleeding and hCG descending to normal in observation group were shorter than those of control group，the intrauterine residual and uterine involution in observation group were better than those of control group，the differences were statistically significant（P<0.05）.Conclusion：Hysteroscopy in treatment of cornual pregnancy is minimally invasive，safe，effective and inexpensive，and it has high feasibility.

【Key words】 Hysteroscopy; Cornual pregnancy; Routine surgery; Feasibility

First-authors address：Shaoguan Maternal and Child Health Hospital Family Planning Service Center，Shaoguan 512026，China

doi：10.3969/j.issn.1674-4985.2019.08.038

临床上宫角妊娠是指胚胎种植在接近子宫与输卵管开口交界的宫角处，虽然属于腔内妊娠，但由于宫角处子宫肌层较为薄弱，且又是子宫血管、卵巢动静脉和输卵管血管的吻合处，随着孕周增长以及受精卵的发育，会导致宫角肌层进一步变薄并导致严重的大出血，若诊断和抢救延误则危及生命[1-2]。

近年来宫角妊娠发生率不断上升，研究指出子宫及附件的炎症、宫内节育器的使用、性激素分泌异常、体外受精、胚胎移植、先天性宫颈发育畸形（过长、憩室等）、排卵过早或延迟均是引起宫角妊娠的危险因素[3-4]。因此临床在诊断明确后需要及时进行手术治疗[5]，随着微创和各类腔镜技术的广泛应用，使得宫角妊娠的临床诊疗效果获得了极大的提升[6]，本研究试就常规腹腔镜切除和B超吸宫术与宫腔镜手术之间的手术效果进行比较分析，为临床宫腔镜手术治疗的可行性提供参考依据，现报道如下。……