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目的探讨残角子宫妊娠的临床特征、诊断及治疗现状,提高临床医生对该病的认识。方法回顾性分析2010年1月至2016年9月福建省妇幼保健院诊治的10例残角子宫妊娠患者的临床病例资料。结果残角子宫妊娠的主要临床表现是停经后阴道出血和下腹痛,根据患者病史及妇科彩超检查等可协助诊断。10例患者均手术治疗,其中腹腔镜术8例,开腹术1例,宫腔镜检查+开腹术1例。有8例患者术后顺利怀孕,其中7例足月妊娠并产下活婴,1例目前怀孕5~+月。结论残角子宫妊娠罕见,临床表现无特异性,但对患者危害极大。诊断一旦成立,应尽早手术切除残角子宫及同侧输卵管,优选腹腔镜手术治疗。早发现、早诊断、早处理,不仅可避免不良妊娠结局,还可明显改善患者下一次的生殖结局。
Objective To investigate the clinical features, diagnosis and treatment status of rudimentary horns uterine pregnancy and to improve clinicians’ understanding of the disease. Methods The clinical data of 10 cases of rudimentary horns uterine pregnancy diagnosed and treated by Fujian MCH Hospital from January 2010 to September 2016 were retrospectively analyzed. Results Residual angle uterus pregnancy is the main clinical manifestations of vaginal bleeding after menopause and lower abdominal pain, according to the patient’s history and gynecological ultrasound examination can help diagnose. All 10 patients underwent surgery, including 8 cases of laparoscopy, 1 case of laparotomy and 1 case of hysteroscopy + laparotomy. Eight patients were successfully pregnant, including seven full-term pregnancies and live births, and one was currently pregnant between 5 and + months. Conclusion Residual horn uterus pregnancy rare, clinical manifestations of non-specific, but great harm to patients. Once the diagnosis is established, as soon as possible surgical removal of residual horn uterus and ipsilateral fallopian tubes, preferably laparoscopic surgery. Early detection, early diagnosis, early treatment, not only to avoid adverse pregnancy outcomes, but also significantly improve the patient’s next genital outcome.