摘要
目的:加强对残角子宫的临床表现、诊断、治疗的认识。方法:对2013年3月至2016年1月湖北省妇幼保健院妇科收治的残角子宫患者15例进行回顾性分析。结果:(1)非妊娠时诊断2例,妊娠时诊断12例(其中残角子宫妊娠9例,残角子宫合并同侧输卵管妊娠3例)。(2)残角子宫妊娠破裂者3例(Ⅱb型2例,Ⅱa型1例),2例为早期妊娠时发生(Ⅱb型),1例为妊娠中期发生(Ⅱa型)。(3)术中见同侧输卵管缺如1例,同侧卵巢缺如1例,2例患者术前均无腹部手术史。(4)14例病例均经过手术明确诊断,所有切除的残角子宫均行病理检查,其中3例为肌性结构(Ⅱc型),其余均见内膜组织(Ⅱa型1例,Ⅱb型10例)。两侧子宫肌性连接者3例,部分纤维带连接者10例,完全不相连者1例。(5)发现残角子宫前无孕产史者11例,有孕产史者4例,其中1例顺产1胎,1例剖宫产1胎,2例曾有人流史(1例人流1次,1例人流3次,以往检查均未发现合并残角子宫)。(6)手术切除残角子宫14例,其中开腹手术3例,腹腔镜手术11例。结论:残角子宫容易误诊,残角子宫妊娠时易发生严重的并发症,在妊娠早期确诊十分重要,诊断主要依靠B超检查,非孕期及早孕期的残角子宫切除手术建议使用腹腔镜完成,在切除残角子宫的同时建议切除同侧输卵管。
Objectives： To improve the awareness of the clinical feature,diagnosis and treatment of rudimentary uterine horn. Methods： The clinical data of 15 patients with rudimentary uterine horn cured in Hubei Province Maternal and Child Care Service Centre from March 2013 to January 2016 were analyzed retrospectively.Results：（ 1） 2 cases were diagnosed during non- pregnancy; 12 cases were diagnosed during pregnancy（ 9 cases of uterine horn pregnancy,3 cases of residual horn uterus with ipsilateral tubal pregnancy）.（ 2） Rupture of uterine horn was found in 3 cases（ 2 cases of Ⅱb type during early pregnancy,1 cases of type Ⅱa during second trimester pregnancy）.（ 3） 1 case was with no ipsilateral fallopian tube and 1 case was observed to have no ipsilateral ovarian during the operation.. There was no abdominal operation history in both patients before operation.（ 4） All the 14 cases were diagnosed by surgery. Pathological examinations were performed in all the rudimentary uterine horns. 3cases were with muscular structure（ Ⅱc type）,and endometrial tissue was found in other cases（ 1 cases of Ⅱ a type,10 cases of Ⅱ b type）.（ 5） 11 cases had no pregnancy history and 4 cases with pregnancy history,including1 case of natural labour,a case with cesarean section and 2 cases with a history of induced abortion.（ 6） Surgical removal of uterine horn were performed on 14 cases,including 3 of open surgery and 11 of laparoscopic surgery.Conclusion： Rudimentary uterine horn is easy to misdiagnose in pregnancy,so early diagnosis is very important. Diagnosis mainly depends on ultrasound test. Resection for patient during non- pregnancy or early pregnancy is recommended by laparoscope,while treated by removing the rudimentary uterine horn and ipsilateral fallopian tube.
作者
雷燕
王燕
周利敏
LEI Yan WANG Yan ZHOU Limin.(Department of Gynecology, Hubei Province Maternal and Child ren Health Care Hospital, Wuhan 430070, Hubei, Chin)
出处
《中国性科学》
2017年第1期30-32,共3页
Chinese Journal of Human Sexuality
关键词
残角子宫
妊娠
手术方式
Rudimentary uterine horn
Pregnancy
Operation method
