妊娠合并子宫肌瘤46例诊治分析

Diagnosis and treatment analysis of 46 patients with pregnancy complicated by uterine fibroids

目的探讨妊娠合并子宫肌瘤对妊娠与分娩的影响及合理的临床诊治方法。方法对2007年6月～2012年6月在本院就诊的46例妊娠合并子宫肌瘤患者的临床资料进行回顾性分析，包括其肌瘤大小、位置、类型、分娩方式、治疗效果及并发症情况。结果46例患者中，12例经阴道分娩，5例剖宫产，22例剖宫产同时行肌瘤剔除，3例早产，4例流产。单纯剖宫产与剖宫产同时剔除肌瘤患者的手术时间差异有统计学意义（P〈0．05）；术中及术后的出血量、住院时间差异无统计学意义（P〉0．05）。结论妊娠合并子宫肌瘤对孕妇及胎儿的影响较大，根据不同的孕期、肌瘤的大小和位置选择合适的诊治方案极其重要，在剖宫产的同时剔除肌瘤是较为可行的治疗方案。

Objective To investigate the influence of pregnancy complicated by uterine fibroids on pregnancy and delivery and the rational clinical diagnosis and treatment methods. Methods Clinical data of 46 patients with pregnancy complicated by uterine fibroids treated in our hospital from June 2007 to June 2012 were analyzed retrospectively,ineluding fibroid size,location,type,mode of delivery,treatment effect and complications. Results Of the 46 patients,12 patients had vaginal delivery,5 patients had cesarean delivery,22 patients had cesarean section and simultaneous myomeetomy,3 patients had premature delivery and 4 patients had abortion.The simple cesarean delivery and cesarean section and remove fibroids patients had statistically significant difference in the surgical time （P〈0.05）,but did not have statistical differences in the intraoperative and postoperative blood loss and hospitalization time （P〉0.05）.Conclusion Pregnancy complicated by uterine fibroids has large influence on both gravidae and fetuses;Therefore,it is of great importance to select the appropriate diagnosis and treatment regimen according to the gestation and the size and location of uterine fibroids.Cesarean section and simultaneous myomectomy is a feasible treatment regimen.