Objective: To evaluate the therapeutic methods and their effects on patients with cornual pregnancies.
Methods: A retrospective study was performed on 83 patients, who were diagnosed as cornual pregnancy at Drum Tower Hospital from June 2010 to April 2015. The patients were divided into 5 groups: a laparoscope group, angle resection and uterine repair guided by laparoscope (n=16); a surgery group, operated with angle resection and uterine repair (n=49); an abortion group, guided by ultrasound or laparoscope (n=6); a drug group, treated by methotrexate and mifepristone (n=8) and a pregnancy bursal puncture group (n=4). We compared the general conditions, surgery circumstances and average days in hospital among the laparoscope group, the surgery group, and the abortion group. Moreover, we also investigated the outcomes of the drug group and pregnancy bursal puncture group.
Results: Compared with the surgery group, the intraoperative blood loss in the laparoscope group and abortion group was less (P<0.05). The length of procedure and average days in hospital between the surgery group and the laparoscope group were not statistically significant (P>0.05). The length of procedure in the abortion group was less than that in the laparoscope group or the surgery group (P<0.05). The cure rate was 100%.
Conclusion: The therapeutic methods based on patient's condition can improve the curative effect and prognosis in cornual pregnancy, which can keep the integrity of generative organs with less injury. The laparoscope might be a main therapeutic method for cornual pregnancy due to its safety, effectiveness, and minimal invasion.
目的：探讨宫角妊娠的临床治疗方案，分析不同治疗方法的临床结局。方法：回顾性分析2010年6月至2015年4月南京大学医学院附属鼓楼医院收治的83例宫角妊娠患者的临床资料，将83例患者分为5组：腹腔镜下宫角切除+子宫修补组(腹腔镜组，n=16)、开腹宫角切除+子宫修补组(开腹组，n=49)、吸宫组(n=6)、氨甲蝶呤(methotrexate，MTX)+米非司酮药物保守治疗组(保守组，n=8)、B超引导下妊娠囊注射药物组(减胎组，n=4)。比较腹腔镜组、开腹组与吸宫组术前一般情况、手术情况及住院天数；调查保守组和减胎组的治疗结局。结果：腹腔镜组、开腹组与吸宫组术前一般情况(年龄、停经天数、流产次数、阴道产、剖宫产次数、术前术后HCG值)及住院天数比较，差异无统计学意义(P>0.05)。术中出血量开腹组[(136.88±75.37) mL]多于腹腔镜组[(102.04±80.60) mL，P<0.05]和吸宫组[(50.00±41.77) mL，P<0.05]，腹腔镜组与吸宫组术中出血量比较，差异无统计学意义(P>0.05)。手术时间开腹组[(65.04±18.89) min]与腹腔镜组[60.83±12.37) min]比较，差异无统计学意义(P>0.05)，吸宫组[(20.83±10.69) min]短于腹腔镜组及开腹组(P<0.05)。保守治疗及减胎组的治疗均成功。5种方法的治愈率为100%，无子宫切除病例。结论：根据个体情况选择不同治疗方案可能改善宫角妊娠患者的疗效，以最小的损伤途径保持生殖器官的完整性；腹腔镜手术安全、有效、微创，已成为宫角妊娠治疗的主要手段。.