国际妇产科学杂志 ›› 2017, Vol. 44 ›› Issue (1): 91-94.

• 论著 • 上一篇    下一篇

子宫肌壁间妊娠的临床分析

张惠惠1,李爱军2   

  1. 1. 郑州大学第一附属医院
    2. 郑州大学第一附属医院妇产科
  • 收稿日期:2016-07-05 修回日期:2016-11-14 出版日期:2017-02-15 发布日期:2017-03-28
  • 通讯作者: 张惠惠 E-mail:18739909277@163.com
  • 基金资助:
    河南省高等学校重点科研项目计划

Clinical analysis of intramural pregnancy

  • Received:2016-07-05 Revised:2016-11-14 Published:2017-02-15 Online:2017-03-28
  • Contact: Hui HuiZHANG E-mail:18739909277@163.com

摘要: 目的:探讨子宫肌壁间妊娠的临床特征、治疗效果、发病因素、鉴别诊断及诊疗手段。方法:回顾性分析我院近5年收治的4例子宫肌壁间妊娠患者的既往盆腔手术病史、临床特征、辅助检查、诊疗手段及病理结果,探讨子宫肌壁间妊娠发病因素、鉴别、诊治手段。结果:4例均为宫角肌壁间妊娠(包块型)。超声及MRI误诊为宫角妊娠以及滋养细胞肿瘤不除外。4例均行宫腹腔镜联合探查术,治疗后随访血HCG均降至正常范围。结论:临床上对于清宫不成功,清宫后血HCG持续不降并伴阴道出血,而超声、MRI等辅助检查提示子宫肌层占位并血流信号丰富等患者应高度警惕,尽早诊治。

关键词: 子宫肌壁间妊娠, 滋养细胞肿瘤, 鉴别诊断, 诊断, 治疗

Abstract: Objective To identify the clinical features treatment effects risk factors differential diagnosis and treatment of the intramural pregnancy. Methods Retrospective analysis the history of surgery clinical features auxiliary examination diagnosis treatment and pathologic result on 4 patients admitted to our hospital with intramural pregnancy in 5 years. To understand the risk factors differential diagnosis and treatment of the intramural pregnancy. Result Four patients all belong to the mass type of the intramural pregnancy. B-mode MRI diagnoses pregnancy in uterine horn and gestational trophoblastic neoplasia. All of the four patients accept hysteroscopy combined with laparoscopy surgery and supervise HCG drop to the normal level. Conclusions In the clinical doctor should pay attention to the patient of incomplete abortion,HCG can not drop to the normal level or increase,vaginal bleeding and B-mode MRI according to mesometrium mass .

Key words: intramural pregnancy, gestational trophoblastic neoplasia, differential diagnosis, diagnosis, treatment