妊娠合并子宫肌瘤行剖宫产术中肌瘤剔除的临床效果观察(1)
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[摘要] 目的：研究妊娠合并子宫肌瘤患者行剖宫产术中肌瘤剔除的临床效果。方法：选取2003年1月～2010年12月于本院进行治疗的219例妊娠合并子宫肌瘤患者为研究对象，上述患者均无妊娠合并症、内外科合并症及肌瘤剔除手术禁忌。将其随机分为治疗组(剖宫产术中肌瘤剔除组)109例和对照组(仅行子宫下段剖宫产术组)110例，后将两组患者平均出血量、术后平均住院时间及产褥病率、术后并发症发生率进行统计及比较。结果：治疗组患者平均出血量及产褥病率、术后并发症发生率明显低于对照组，P<0.05 ，差异有统计学意义，而两组患者术后平均住院时间比较，P>0.05，差异无统计学意义。结论：妊娠合并子宫肌瘤患者在剖宫产术中剔除肌瘤损伤相对较小，治疗效果好，值得在妊娠合并子宫肌瘤患者治疗中广泛应用。
[关键词] 妊娠合并子宫肌瘤；剖宫产术；肌瘤剔除；临床效果
[中图分类号] R737.33 [文献标识码]A[文章编号]1674-4721(2011)08(a)-044-02
Observation of outcomes after hysteromyoma ectomy in the pregnant patients during cesarean section
ZHONG Shanshan
Department of Gynaecology and Obstetrics, Maternal and Child Health Hospital of Taishan City, Guangdong Province, Taishan 529200, China
[Abstract] Objective: To study the outcomes after hysteromyoma ectomy in the pregnant patients during cesarean section. Methods: From January 2003 to December 2010, 219 patients with hysteromyoma underwent cesarean section. The patients were randomly divided into study group (n=109) and control group (n=110) based on receiving hysteromyoma ectomy or not. The average amount of haemorrhage, the day of hospital stay, rate of puerperal morbidity, the rate of postoperative complications of the groups were compared and analyzed. Results: The average amount of haemorrhage, rate of puerperal morbidity, the rate of postoperative complication of the study group were lower than those of the control group with significant difference (P<0.05). The average time of hospital stay of the study group was similar with that of the control group with no significant difference (P>0.05). Conclusion: Hysteromyoma ectomy during cesarean section can be less impairment to the pregnant patients. We suggest to perform the procedure in the patients.
[Key words] Pregnancy with hysteromyoma; Cesarean section; Hysteromyoma ectomy; Clinic outcomes
子宫肌瘤是最常见的女性生殖道肿瘤之一，其中良性肿瘤多见，妊娠合并子宫肌瘤是孕产妇妊娠期间较为常见的合并症，因为肌瘤体积小且没有任何不适症状，所以不易发现[1]。由于妊娠时孕妇子宫血运丰富，一般边界比较清晰，容易分离，所以在剖宫产术中根据具体情况将肿瘤剔除会降低感染机会，又减少了再次手术，但术后不会延长住院时间。所以，临床妇科医师主张在剖宫产的同时将子宫肌瘤剔除[2]。妊娠合并子宫肌瘤的体积、类型、部位以及肌瘤是否发生变性对妊娠、分娩可造成不同程度的影响，因此，临床对本病的治疗方式不同，导致治疗后的结局也有一定的差异[3]。本文中笔者就行剖宫产术中将肌瘤剔除与仅行子宫下段剖宫产术治疗妊娠合并子宫肌瘤的两组患者平均出血量、术后平均住院时间及产褥病率、术后并发症发生率观察比较 ......
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