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目的探讨子宫特殊部位妊娠的临床特点。方法将79例子宫特殊部位妊娠患者分为宫颈妊娠、瘢痕部位妊娠及宫角妊娠三组,分析其诊断、治疗及随访结果。结果 (1)宫颈妊娠8例,全子宫切除2例,接受介入或甲氨蝶呤(MTX)肌注治疗6例,血人绒毛膜促性腺激素(HCG)6.9周后降至正常;(2)瘢痕部位妊娠24例,全子宫切除2例,接受介入或MTX肌注22例,辅助清宫或宫腔镜治疗,血HCG 7.9周后降至正常;(3)宫角妊娠47例,宫角部分切除10例,接受MTX肌注辅助清宫或宫腔镜治疗37例,血HCG 7.7周后降至正常。结论宫颈妊娠、瘢痕部位妊娠及宫角妊娠目前最主要的辅助诊断方法是B超结合HCG检查。瘢痕妊娠与宫颈妊娠治疗首选子宫动脉栓塞,宫角妊娠患者首选MTX注射联合宫腔镜治疗。
Objective To investigate the clinical features of special part of uterus during pregnancy. Methods 79 cases of special part of uterine pregnancy were divided into three groups: cervical pregnancy, scar pregnancy and cornual pregnancy. The diagnosis, treatment and follow-up results were analyzed. Results (1) Cervical pregnancy in 8 cases and total hysterectomy in 2 cases received interventional or methotrexate (MTX) intramuscular injection in 6 cases, blood human chorionic gonadotropin (HCG) decreased to normal after 6.9 weeks; (2) ) 24 cases of scar pregnancy, hysterectomy in 2 cases, interventional or MTX intramuscular injection in 22 cases assisted by hysteroscopy or treatment, serum HCG decreased to normal after 7.9 weeks; (3) 47 cases of uterine horn pregnancy, Palace angle Partial resection in 10 cases, receiving MTX intramuscular injection assisted hysteroscopy or treatment of 37 cases of HCG decreased to normal after 7.7 weeks. Conclusion The most important auxiliary diagnostic method for cervical pregnancy, scar pregnancy and uterine horn pregnancy is B-ultrasonography combined with HCG examination. Scar pregnancy and cervical pregnancy treatment of choice for uterine artery embolism, uterine horn pregnancy preferred MTX injection combined with hysteroscopic treatment.