533例剖宫产术中妊娠合并子宫肌瘤处理的临床研究

Myomectomy performed during cesarean section：an analysis of 533 cases

目的探讨剖宫产术中剔除子宫肌瘤的安全性和可行性。方法回顾性分析长宁区妇幼保健院2003年1月1日至2008年7月31日共533例妊娠合并子宫肌瘤患者，其中469例剖宫产术中同时行肌瘤剔除术，64例行单纯剖宫产术，比较两组患者的平均手术时间、术中术后失血量、术后病率及平均住院天数等情况。结果两组患者术中及术后出血量、手术前后血红蛋白差值、术后病率、术后住院天数比较均无显著性差异（P〉0．05），两组手术时间比较差异有显著意义（P〈0．05）。结论剖宫产时合理剔除肌瘤是安全可行的。

Objective To determine whether myomectomy at the time of caesarean section is feasible and safe. Methods 533 women who had uterine fibroids in pregnancy were studied between January 1 st 2003 and july 31th 2008,in which 469 patients underwent caesarean section and simultaneous myomectomy, and 64 women underwent caesarean section alone. The two groups were respectively analyzed between pre and post-operative haematocrit levels, duration of operation and length of hospital day, blood loss and post-operative complication. Results There were no significant differences between the groups in the blood loss,pre and post-operative haematocrit levels, post-operative complication and length of hospital day,but the mean duration of operation was longer in the group of caesarean myomectomy than the control group. Conclusion Caesarean myomectomy is a safe procedure.