目的:总结残角子宫合并单角子宫各型的临床特征、分析诊断及处理要点。方法:回顾分析我院收治的155例残角子宫合并单角子宫(U4型女性先天性生殖道畸形)的临床资料。结果:(1)U4a型与U4b型患者的就诊年龄、重度痛经、有自然流产史或不孕史、合并子宫内膜异位症等方面比较,差异均有统计学意义(P<0.001)。(2)患者术前二维超声、三维超声、核磁共振诊断符合率分别为87.7%、97.2%和97.4%。(3)32例为妊娠晚期行子宫下段横切口剖宫产术;其余为妇科手术。U4a型中,2例行通液术或卵巢囊肿剥除术,其余均行腹腔镜或经腹残角子宫和/或输卵管切除。U4b型患者均未切除残角及输卵管。(4)与开腹组比较,腹腔镜组术中出血少、手术时间短、术后住院日短,差异有统计学意义。(5)术后随访60例妊娠,包括宫内妊娠55例,自然流产5例,无异位妊娠发生。结论:核磁共振检查及三维超声有助于提高残角子宫的诊断率。单角子宫合并残角子宫型别不同,其临床特征及手术治疗方案亦有差异。 OBJECTIVE: To summarize the clinical features of various types of uterine horn unilateral uterus, analyze the diagnosis and treatment points. Methods: The clinical data of 155 rudimentary horn unicompartmental unicorn uterus (U4 female genital tract deformity) admitted to our hospital were retrospectively analyzed. Results: (1) There were significant differences in the age of patients with U4a and U4b type of patients, severe dysmenorrhea, history of spontaneous abortion, history of infertility, and endometriosis (P <0.001). (2) The preoperative two-dimensional ultrasound, three-dimensional ultrasound, MRI diagnostic accuracy rates were 87.7%, 97.2% and 97.4%. (3) 32 cases were performed cesarean section in the third trimester underwent transverse incision in the third trimester of pregnancy; the others were gynecological operations. U4a type, 2 cases of liquid or ovarian cyst surgery, the rest were performed laparoscopic or perineal horn and / or fallopian tube resection. U4b patients were not removed residual angle and fallopian tubes. (4) Compared with the open group, laparoscopic group less bleeding, shorter operative time, shorter postoperative hospital stay, the difference was statistically significant. (5) Follow-up 60 cases of pregnancy, including 55 cases of intrauterine pregnancy, spontaneous abortion in 5 cases, no ectopic pregnancy. Conclusion: MRI and three-dimensional ultrasound help to improve the diagnosis of rudimentary horn uterus. Single angle uterine horn remnant uterus with different types, the clinical features and surgical treatment programs are also different.