减少子宫肌瘤剔除术后阴道出血的探讨

Ways to reduce vaginal bleeding after uterine myomectomy

目的:探讨子宫肌瘤剔除术后阴道出血的相关因素及术中诊刮在减少肌瘤剔除术后阴道出血应用的临床价值。方法:选择2008年1月至2010年2月因子宫肌瘤在我院行肌瘤剔除术的患者78例,记录术后阴道出血;从以上患者中选肌壁间肌瘤30例为对照组(A组)。2010年3月至2011年3月我院肌壁间肌瘤剔除术中子宫内膜诊刮患者30例为研究组(B组),比较术后阴道出血。结果:肌瘤剔除术后阴道出血与肌瘤的位置有关,黏膜下、肌壁间、浆膜下3者有极显著性差异(P<0.01);B组术后阴道出血明显少于A组,有极显著性差异(P<0.01)。结论:肌瘤剔除术后阴道出血与肌瘤生长部位有关,与子宫肌瘤患者伴发内膜病变有关,肌瘤剔除术中进行诊刮术,能明显减少术后阴道出血,副反应小,值得临床推广。

Objective： To investigate the related factors causing vaginal bleeding after uterine myomectomy and the clinical significance of diagnostic curettage during uterine myomectomy in reducing vaginal bleeding. Methods：78 cases of single uterine myomas performed uterine myomectomy in our hospital from Jan. 2008 to Feb. 2010 were retrospectively studied to observe the vaginal bleeding volume and bleeding days of the patients after operations. Of the above-mentioned 78 cases, 30 patients with intramural myoma were selected as the control group （Group A）, while another 30 cases with single uterine myomas performed myomectomy and diagnostic curettage during uterine myomectomy in our hospital from March, 2010 to March, 2011 were selected as the research group （Group B）. The vaginal bleedi myomectomy, the vaginal blee ng din volumes of both groups were compared. Results：After the uterine g volumes and bleeding days were related to the locations of the uterine myomas, and the comparision between submucous, intramural and subserous myomas was of significant difference （P〈0. 01）. The postoperative vaginal bleeding volume and bleeding days of Group B were less than those of Group A, which were of remarkable difference （P〈0. 01）. Con- clusion.It has been found that vaginal bleeding volume after uterine myomectomy is related to the location of uterine myomas and endometrial lesions of the patients. Uterine myomectomy and the diagnostic curettage during uterine myomectomy can remarkably reduce the bleeding volume and it is with less side reaction and worthy of clinical applica po tio stoperative vaginal n.