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目的:探讨子宫特殊部位妊娠的临床诊断及处理。方法:回顾性分析2005年7月至2010年12月我院收治的18例子宫特殊部位妊娠患者的临床表现、诊断、处理及预后。结果:宫颈妊娠6例、宫角妊娠6例、残角子宫妊娠2例、子宫剖宫产瘢痕处妊娠4例。宫颈妊娠通过子宫动脉介入栓塞后清宫术治愈;宫角妊娠经MTX保守治疗后在超声或宫腔镜引导下清宫术痊愈。残角子宫妊娠均行残角子宫切除术治愈。子宫剖宫产瘢痕处妊娠根据分型分别行超声引导下清宫+水囊压迫、局部注射MTX保守治疗治愈。结论:子宫特殊部位妊娠病情凶险,临床表现各异,但有其特异性,超声辅助检查有助于早期诊断,MTX、子宫动脉介入栓塞治疗后刮宫是有效治疗手段。
Objective: To investigate the clinical diagnosis and treatment of special parts of uterus during pregnancy. Methods: The clinical manifestations, diagnosis, treatment and prognosis of 18 pregnant women with special uterus treated in our hospital from July 2005 to December 2010 were retrospectively analyzed. Results: 6 cases of cervical pregnancy, 6 cases of uterine horn pregnancy, 2 cases of residual horn uterine pregnancy, 4 cases of cesarean scar pregnancy. Cervical pregnancy by uterine artery embolization curettage; Palace pregnancy by MTX conservative treatment under the guidance of ultrasound or hysteroscopic curettage cure. Residual angle uterine pregnancy ruptured horn hysterectomy were cured. Uterine cesarean scar pregnancy according to the type under the guidance of ultrasound under the pressure of the Qing + water sac, local injection of MTX conservative treatment of cure. Conclusion: Pregnancy in special part of uterus is extremely dangerous and has different clinical manifestations. Ultrasound-assisted examination is helpful for early diagnosis. Dilatation and curettage after MTX and uterine arterial embolization is an effective treatment.