妊娠合并子宫肌瘤术后发生感染的相关因素分析

Infection-related factors after hysteromyomectomy for pregnant women with uterine myoma

目的探讨妊娠合并子宫肌瘤的孕妇在进行剖宫产手术的同时行子宫肌瘤切除术后发生术后感染的相关因素。方法随机选择剖宫产并行子宫肌瘤切除术的患者108例，记录患者进行手术后的感染发生率，并分析监测妊娠合并子宫肌瘤患者发生术后感染的相关因素。结果108例患者中12例发生术后感染，感染率为11．1％。通过患者发生术后感染的相关因素分析得：患者贫血、阴道镜检查次数≥3次、手术时间≥85min及术中出血量≥200ml这些因素均显著增大患者术后感染率，差异具有统计学意义（χ^2=5．59，P=0．024；χ^212．27，P=0．002；χ^2=6．59，P=0．014；χ^2=3．38，P=0．044）；而患者体内子宫肌瘤的个数及大小，对患者术后感染率无影响，差异无统计学意义（P〉0．05）。结论妊娠合并子宫肌瘤术后发生感染的相关因素较多，对患者于术前及术后采取恰当及必要的干预措施不仅可以提高手术的疗效、降低手术风险，还可以有效地减少手术后患者不良并发症的发生、降低患者手术后感染率。

Objective To investigate the infection-related factors after hysteromyomectomy and cesarean section at the same time for pregnant women with uterine myoma. Methods 108 patients undertaking cesarean section and hysteromyomectomy were randomly selected. After the operation, the incidence of infection was recorded and the infection-related factors were analyzed. Results Among the 108 patients, 12 were infected, with a infection rate of 11.1%. The analysis of infection-related factors showed that anemia, colposeopy examination more than 3 times, operative time longer than 85 min, and intraoperative bleeding volume over 200 ml significantly increased postoperative infection rate, with statistical differences （χ^2=5-59, P=0.024; χ^2=12-27, P=0.002; χ^2=6-59, P=0.014;χ^2=3.38, P=0.044）. Uterine myoma number and size had no effect on postoperative infection rate. Conclusions There are many factors causing infection after hysteromyomectomy and cesarean section at the same time. Corresponding intervention measures before and after the operation can improve the operative effect, lower the operative risk, decrease the incidences of adverse complication and postoperative infection.