宫角妊娠的治疗方法及疗效分析

发布时间：2018-06-11 16:27

本文选题：宫角妊娠 + 腹腔镜　；参考：《中南大学学报(医学版)》2015年12期

【摘要】：目的:探讨宫角妊娠的临床治疗方案,分析不同治疗方法的临床结局。方法:回顾性分析2010年6月至2015年4月南京大学医学院附属鼓楼医院收治的83例宫角妊娠患者的临床资料,将83例患者分为5组:腹腔镜下宫角切除+子宫修补组(腹腔镜组,n=16)、开腹宫角切除+子宫修补组(开腹组,n=49)、吸宫组(n=6)、氨甲蝶呤(methotrexate,MTX)+米非司酮药物保守治疗组(保守组,n=8)、B超引导下妊娠囊注射药物组(减胎组,n=4)。比较腹腔镜组、开腹组与吸宫组术前一般情况、手术情况及住院天数;调查保守组和减胎组的治疗结局。结果:腹腔镜组、开腹组与吸宫组术前一般情况(年龄、停经天数、流产次数、阴道产、剖宫产次数、术前术后HCG值)及住院天数比较,差异无统计学意义(P0.05)。术中出血量开腹组[(136.88±75.37)m L]多于腹腔镜组[(102.04±80.60)m L,P0.05]和吸宫组[(50.00±41.77)m L,P0.05],腹腔镜组与吸宫组术中出血量比较,差异无统计学意义(P0.05)。手术时间开腹组[(65.04±18.89)min]与腹腔镜组[60.83±12.37)min]比较,差异无统计学意义(P0.05),吸宫组[(20.83±10.69)min]短于腹腔镜组及开腹组(P0.05)。保守治疗及减胎组的治疗均成功。5种方法的治愈率为100%,无子宫切除病例。结论:根据个体情况选择不同治疗方案可能改善宫角妊娠患者的疗效,以最小的损伤途径保持生殖器官的完整性;腹腔镜手术安全、有效、微创,已成为宫角妊娠治疗的主要手段。
[Abstract]:Objective: to discuss the clinical treatment scheme of cornual pregnancy and analyze the clinical outcome of different treatment methods. Methods: a retrospective analysis of the clinical data of 83 cases of cornual pregnancy admitted from June 2010 to April 2015 in the Affiliated Drum Tower Hospital of Nanjing University Medical College, 83 cases were divided into 5 groups: Laparoscopy hysterectomy + uterine repair group (laparoscope group) N=16), the laparotomy uterine horn resection + uterine repair group (open abdominal group, n=49), the uterine suction group (n=6), the methotrexate (methotrexate, MTX) + mifepristone medicine conservative treatment group (conservative group, n=8), the B-ultrasound guided pregnancy capsule injection group (fetal reduction group, n=4). Compare the abdominal hysteroscopy group, the laparotomy group and the uterine suction group before operation, the operation and the hospital days; investigation Results: there was no significant difference between the laparoscopy group, the laparotomy group and the uterine sucking group (age, the number of abortions, the number of abortions, the vaginal delivery, the number of cesarean section, the HCG value before and after the operation) and the number of days in the hospital (P0.05). (136.88 + 75.37) m L] in the intraoperative bleeding volume was more than that of the laparoscopy group [102.04 + 80.60) m L, P0.05] and uterine suction Group [(50 + 41.77) m L, P0.05], there was no significant difference in the amount of bleeding during the operation of the laparoscopy group and the uterine suction group (P0.05). There was no statistical significance (P0.05) in the operation time of the laparotomy group [(65.04 + 18.89) min] and the laparoscope group [60.83 + 12.37) min]. [20.83 + 10.69) was shorter than the laparoscopy group and the opening. Abdominal group (P0.05). The cure rate of conservative treatment and fetus reduction group was 100%, no hysterectomy cases were successful. Conclusion: choosing different treatments according to individual condition may improve the curative effect of the patients with uterine horn pregnancy and maintain the integrity of reproductive organs with the smallest way of injury; the laparoscopic operation is safe, effective and minimally invasive. The main means for the treatment of cornual pregnancy.
【作者单位】：南京大学医学院附属鼓楼医院妇产科;
【基金】：国家自然科学基金青年科学基金(81300499)~~
【分类号】：R714.224

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