子宫特殊部位妊娠18例分析

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官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。

Analysis of 18 Cases with Uterine Ectopic Pregnancy

Objective： To discuss the diagnosis and treatment strategy of Uterine ectopic pregnancy. Methods： A total of 18 cases of uterine ectopic pregnancy admitted to Beijing Chao-Yang Hospital from July 2005 to Dec 2010 were analyzed retrospectively, and the clinical characteristics, management and outcome of these 18 women were reviewed. Results： Among the 18 Uterine ectopic pregnancy women, there are 6 cases of cervical pregnancy,6 cases of cornua uteri pregnancy, and 2 cases of rudimentary uterine horn pregnancy, and 4 cases cesarean scar pregnancy. Treatment of these cases included methotrexate （MTX） therapy, bilateral uterine artery embolism （UAE）, curettage and hysterectomy, curettage after UAE （6 cases cervical pregnancy）, curettage after MTX （6 cases cornua uteri pregnancy）, partial hysterectomy （2 cases rudimentary uterine horn pregnancy）, curettage after MTX and compression hemostasis with Foley airbag catheter （4 cases cesarean scar pregnancy）. Conclusions： Uterine ectopic pregnancy is not common and can be easily misdiagnosed and color ultrasound scan is important in its early diagnosis. UAE combined with MTX followed by curettage is an effective treatment.