宫剖产术中行子宫肌瘤剔除术疗效剖析.docVIP

宫剖产术中行子宫肌瘤剔除术疗效剖析 　　【摘要】 目的 探讨在剖宫产术中行子宫肌瘤剔除的可行性。方法 回顾性分析208例妊娠合并子宫肌瘤患者,其中108例为行剖宫产及子宫肌瘤剔除术组(CM=caesarean section and myomectomy),100例为单纯行剖宫产术组即非剔除术组(NCM=caesarean section with no myomectomy),按单个瘤体最大直径分三个层次(?0.05);②5.0 cm≤?8 cm时UM组与NUM组比较OT、OBL增加,LW、LT减少,差异显著(P0.05);③?≥8 cm UMR组与NUMR组比较OT、OBL增加, LW、LT减少,差异显著(P0.05)。结论 剖宫产术中行子宫肌瘤剔除虽有增加手术时间及出血量的可能,但可以促进产后子宫恢复并避免了二次手术痛苦,在患者病情许可下是安全可行的。 　　【关键词】 妊娠;子宫肌瘤;剖宫产术; 子宫肌瘤剔除术 　　 　　To analysis the therapeutic effect of myomectomy during the process of caesarean section 　　 　　ZHANG Yu, CHEN Sheng-lian, ZHOU Lan-yun, et al.The People’s Hospital of Sihong,Jiangsu, Sihong 223900,China 　　 　　【Abstract】 Objective To evaluate the feasibility of myomectomy during the process of caesarean section.Methods Retrospectively analysis of the total 208 cases suffered leiomyoma uteri during pregnancy, among these cases 108 patients were performed caesarean section and myomectomy (the group of CM), while the other 100 patients were only performed caesarean section (the group of NCM).According to the biggest size of the uterus myoma in every patient, these cases were separated to three levels(?0.05).② 5.0 cm≤?8 cm The results of OT and OBL increased, the LW and LT decreased in the group of UM comparing to NUM, the difference were statisticly significant(P0.05).③?≥8 cm The results were just same as in the level of 5.0 cm≤?8 cm, the difference were statisticly significant(P0.05).Conclusion Although there is the possibility of increasing operation time length and blood loss while performing myomectomy during the process of caesarean section, but it has the advantage of promoting involution of uterus and avoiding the pain of re-operation.So it is safe and feasible to perform myomectomy during the process of caesarean section. 　　【Key words】 Pregnancy; Leiomyoma uteri; Caesarean section; Myomectomy 　　 　　子宫肌瘤是女性生殖道常见的良性肿瘤,妊娠合并子宫肌瘤占妊娠患者的0.1%～3.9%[1],随着生育年龄的推迟及B超检查的普及与检查技术的提高,妊娠合并子宫肌瘤检出率逐年升高。在剖宫产术中是否同时剔除子宫肌瘤尚有争议,本研究中我们回顾性分析妊娠合并子宫肌瘤患者行剖宫产+肌瘤剔除的治疗效果,现