妊娠合并子宫肌瘤红色变性的诊治现状

Current Diagnosis and Treatment for Red Degeneration Associated with Hysteromyoma in Pregnancy

妊娠合并子宫肌瘤红色变性发生于妊娠中、晚期和产褥期,是一种特殊类型的坏死。症状表现为局部持续性腹痛,部分伴发热,白细胞增高;有规律或不规律子宫收缩,肿瘤局部有明显压痛;彩色多普勒显示其内回声强弱不等,瘤内血流信号稀少。诊断需要与妊娠合并子宫肌瘤蒂扭转及子宫扭转急腹症相鉴别。主要采取卧床休息、支持疗法、镇静止痛、抑制宫缩、预防应用抗生素及小剂量肝素等保守治疗为主。如果保守治疗无效,应行手术治疗。

The red degeneration associated with hysteromyoma is a special type of necrosis which tends to be generated during midterm or late-term pregnancy and puerperium.It is manifested by constant abdominal pain with fever,leukocytosis,regular or irregular uterine contractions,obvious tenderness in the corresponding place of hypogastric region;echoes of Color Doppler Flow Imaging shows varying degree of intensity and finite flow signals in the myoma.The diagnosis needs to be distinguished from pregnancy with uterine fibroids′s turn and the abdominal pain caused by uterine torsion.The treatment should mainly adopt conservative treatments such as bed rest,supporting treatment,sedative analgesics,restraining the contractions of uterine,antibiotic prophylaxis and low-dose heparin.If the conservative treatment failed,surgery should be taken.