剖宫产术同时行子宫肌瘤剔除术的临床分析

Myomactomy performed during cesarean section:An analysis of 98 cases

目的探讨妊娠合并子宫肌瘤剖宫产术同时行肌瘤剔除对产后出血、术后并发症发生率、术后住院天数的影响。方法妊娠合并子宫肌瘤产妇98例在剖宫产术中同时行肌瘤剔除,与100例单纯行剖宫产术的产妇对照。结果术后24小时出血量、术后并发症发生率、术后住院天数,肌瘤剔除组与单纯剖宫产组比较差异无显著意义(均P>0.05);手术时间肌瘤剔除组与单纯剖宫产组比较差异有显著意义(均P<0.05);术中出血量肌瘤剔除组与单纯剖宫产组差异无显著意义(均P>0.05),但肌瘤直径≥5cm者术中出血量多于直径<5cm者(P<0.05)。结论剖宫产术同时应尽量行子宫肌瘤剔除术,但对于肌瘤直径≥5cm,体质较差的产妇,不主张行肌瘤剔除术。

Objective To study infections of myomactcmy to postpartum hemorrage, occurrence rate after operation and days in patient after operation in pregnant women with hysteromyoma during cesarean section. Methods 98 pregnant women with hysterornyoma received myomactomy in the process of cesarean section which were compared with 100 pregnant women with simple cesarean section. Results There was no significant difference in bleeding volume 24 hours after operation, occurrence rate after operation, days in patient after operation between myomaetcmy group and simple cesarean section group（ P 〉0.05） ; There was significant difference between myomaetomy group and simple cesarean section group（ P 〈 0.05） ;There was no significant difference in hemorrage of operation between myomaetomy group and simple cesarean section group（ P 〉0.05） , but there is significant difference in hemorrage of operation between myoma （diameter≥5cm） and myoma （diameter≥5cm） （ P 〈 0.05）. Conclusion Removing uterus myoma when performing cesarean should be encouraged in order to avoid another operation. But uterus myoma with diameter more than 5cm or weaker healthy are exceptions.