|［摘要］ 目的 探讨宫腔镜冷刀在Ⅰ型宫角妊娠诊治中的应用价值。方法 回顾性分析2020年2月至2022年2月于郑州大学第三附属医院就诊的，经子宫三维阴超及宫腔镜诊断为Ⅰ型宫角妊娠且有生育要求的8例患者的临床资料，均行宫腔镜冷刀胚物清除术，分析其宫角妊娠胚物清除、术中出血、术中是否应用腹腔镜监护、术中是否中转宫角切开或切除、手术时间、术后血人绒毛膜促性腺激素（hCG）下降及子宫恢复等情况。结果 8例患者均在宫腔镜下完成手术，均未发生水中毒、大出血及子宫穿孔。术后hCG恢复正常时间为3～6（4.00±1.07）周，术后1个月复查子宫彩超，宫腔均无胚物残留，术后月经恢复时间为25～42（32.13±5.89）d，术后均无宫腔粘连发生。8例均有生育要求，其中1例已正常分娩，3例在妊娠中期，4例在计划妊娠中。结论 宫腔镜冷刀可用于Ⅰ型宫角妊娠的诊治，可以有效保护子宫内膜，尤其适用于有生育要求的患者。
|关键词: 宫腔镜冷刀 宫角妊娠 生育力保护
|Clinical analysis of 8 cases of type Ⅰ cornual pregnancy treated by hysteroscopic cold knife
QIAO Ming-jing, LUN Bing, SHI Kai-ge, et al.
Department of Gynecology, the Third Affiliated Hospital of Zhengzhou University, Henan 450052, China
|［Abstract］ Objective To explore the clinical application value of hysteroscopic cold knife in the diagnosis and treatment of type Ⅰ cornual pregnancy. Methods From February 2020 to February 2022, the clinical data of 8 patients who had the desire of fertility and were diagnosed with type Ⅰ cornual pregnancy by using three-dimensional vaginal ultrasound and hysteroscopy at the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed. All the patients underwent embryo removal by hysteroscopic cold knife surgery. The clearance of embryonic tissues in the uterine horn, intraoperative hemorrhage, whether laparoscopic monitoring was applied during the operation, whether the uterine horn was incised or excised during the surgery, the duration of the surgery, the trend of postoperative human chorionic gonadotropin(hCG) decline, and the postoperative uterine recovery were analyzed in the patients. Results All the 8 patients underwent hysteroscopic surgery, and none of them suffered from water poisoning, massive bleeding and uterine perforation. The time for hCG to return to normal level after surgery was 3-6(4.00±1.07)weeks. Color ultrasonography was used to reexamine the uterus one month after surgery, and no embryonic residue was found in the uterine cavity. The recovery time of menstruation was 25-42(32.13±5.89)days and no intrauterine adhesions occurred. All the 8 cases had fertility requirements, among whom 1 case had normal delivery, and 3 cases were in the second trimester, and 4 cases were in a planned pregnancy during our follow-up period. Conclusion Hysteroscopic cold knife can be used in the diagnosis and treatment of type Ⅰ cornual pregnancy, which can effectively protect the endometrium and is especially suitable for patients with fertility requirements.
|Key words: Hysteroscopic cold knife Cornual pregnancy Fertility protection