早孕合并子宫肌瘤人工流产术临床分析

Clinical experience in termination of first trimester of pregnancies complicated with hysteromyoma

目的:探讨早孕合并子宫肌瘤患者终止妊娠方式、手术并发症的预防和处理。方法:回顾性分析212例早孕合并子宫肌瘤终止妊娠患者的临床资料。结果:203例行电吸术及钳刮术,2例出血较多,为合并肌壁间肌瘤,直径>5cm。9例行药物流产术,顺利排出胎囊,排出时间平均136min。出血未超过月经量。结论:早孕合并较小子宫肌瘤病例(肌瘤结节<5cm),或者肌瘤位于浆膜下者,手术难度及风险较小。合并多发性、肌壁间子宫肌瘤,以及直径≥5cm的子宫肌瘤患者,人工流产手术并发症的发生率均明显增高。早孕合并子宫肌瘤行药物流产是可行、有效的,在药流过程中,严密观察、及时处理,可减少并发症的发生率。

Objective： To explore the method, precautions and treatments for the complications of termination of first trimester of pregnancy complicated with hysteromyoma. Methods： 212 cases of termination of first trimester of pregnancies complicated with hysteromyoma were retrospectively analyzed. Results： 203 cases took aspiration curettage termination of pregnancy, 2 of them appeared overflow of bleeding, both characterized with intramural myoma, over 5 cm in diameter; 9 cases took medication induced abortion, and all discharged the gestational sac fluently （average 136 minutes）, with common amount of bleeding （not over normal menstruation） . Conclusion： Termination of first trimester of pregnancy takes lower risks, if complicated with small uterine myoma （less than 5 em in diameter） or subserous myoma; or takes remarkably higher risks if complicated with multiple, intramural, or over 5 cm in diameter＇s hysteromyoma. Medication induced abortion is available and sufficient for termination of first trimester of pregnancy complicated with hysteromyoma. Workers should focus on carefully screen and treat the consequence in time to avoid all kinds of complications.