剖宫产同时阻断血管后行子宫肌瘤剔除术的探讨
剖宫产；血管阻断；子宫肌瘤剔除；血红蛋白；术后病率,,剖宫产；血管阻断；子宫肌瘤剔除；血红蛋白；术后病率,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 探讨剖宫产同时行子宫肌瘤剔除术的安全性及阻断血管与非阻断血管手术的比较。方法 回顾性分析2003～2004年两年间北京妇产医院腹壁横切口腹膜内剖宫产同时采取子宫血管阻断止血法行子宫肌瘤剔除术117例，与1992～1994年我院行剖宫产同时子宫肌瘤剔除术(无血管阻断止血法)26例比较平均出血量、血红蛋白下降、住院天数、术后病率情况(肌瘤直径≥5cm)；同时与2003～2004年单纯腹膜内剖宫产110例，比较平均出血量、血红蛋白下降、住院天数、术后病率情况；并对不同部位、不同大小的子宫肌瘤剔除进行比较。结果 血管阻断剖宫产同时行子宫肌瘤剔除术与无血管阻断比较，两组在术中出血量、血红蛋白下降、住院天数、术后病率方面均有统计学差异(P<0.05)；血管阻断剖宫产同时行子宫肌瘤剔除术与单纯剖宫产术比较，两组在术中出血量、血红蛋白下降、住院天数、术后病率方面差异无显著性(P>0.05)；不同部位子宫肌瘤比较，肌壁间肌瘤的术中出血量、血红蛋白下降明显多于浆膜下和黏膜下肌瘤，有统计学差异(P<0.05)，两组住院天数、术后病率差异无显著性(P>0.05)。结论 剖宫产同时采取阻断子宫血管的方法可减少出血及术后病率，同时行子宫肌瘤剔除术是安全、可行的。【关键词】 剖宫产；血管阻断；子宫肌瘤剔除；血红蛋白；术后病率
Feasibility of cesarean with uterus myoma removaling under interdicting blood
WANG Yaling,ZHAI Guirong.Department of Obstetrics and Gynecology,Shunyi Women and Children Care Hospital,Beijing 101300,China
【Abstract】 Objective To investigate the safety and compare the outcome with or without interdicting blood of cesarean with uterus myoma removaling at same time.Methods Retrospective analysis of 117 cases of cesarean with uterus myoma removaling under interdicting blood from 2003 to 2004 and 56 cases without interdicting blood from 1992 to 1994 in Beijing Maternity Hospital for comparison in inhospital days、average bleeding、hemoglobin descending、postoperative morbidity.And 110 cases of simple intraperitoneal cesarean from 2003 to 2004;And comparing uterus myoma in different places and sizes.Results There was notable difference in inhospital days、average bleeding、hemoglobin descending、postoperative morbidity between cesarean with and without interdicting blood.There was no difference between cesarean with uterus myoma removaling under interdicting blood and cesarean only;there was obvious difference in average bleeding、hemoglobin descending between uterus myoma in different places.Conclusion It is safe,feasible that cesarean with uterus myoma removaling under interdicting blood at same time. ......
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