妊娠合并子宫肌瘤78例临床研究

Clinical analysis of 78 cases of pregnancy complicated with hysteromyoma

目的探讨妊娠合并子宫肌瘤的最佳临床处理方法。方法对78例妊娠合并子宫肌瘤患者(观察组)资料进行回顾性分析,并与无子宫肌瘤的孕产妇(对照组)进行对比,分析妊娠合并子宫肌瘤的患者孕期、分娩期各种并发症的发生情况及处理方法。结果观察组先兆流产、先兆早产、胎位异常、胎儿宫内发育迟缓(IUGR)、胎膜早破(PROM)发生率明显高于对照组,比较差异有统计学意义(P<0.05);而前置胎盘、妊娠期糖尿病(GDM)发生率与对照组比较差异无统计学意义(P>0.05)。观察组分娩期脐带绕颈、低体质量儿、早产发生率高于对照组,差异有统计学意义(P<0.05);而胎盘早剥、新生儿窒息、产后出血发生率2组比较差异无统计学意义(P>0.05);观察组剖宫产率71.8%明显高于对照组的52.6%,差异有统计学意义(P<0.05)。有27例在剖宫产同时对子宫肌瘤进行剔除,除手术时间延长外,出血量无明显增加。结论子宫肌瘤可增加孕、产期并发症发生率;而行剖宫产的产妇,术中并行子宫肌瘤摘除术是可行的。

Objective To explore the best clinical treatment for pregnancy complicated with hysteromyoma. Methods78 cases of pregnant women with uterine myoma（ observation group） were analyzed retrospectively,and pregnant women without uterus myoma（ control group） were compared,and the treatment method for the analysis of various complications of pregnancy,childbirth period of pregnancy with uterine fibroids. Results During pregnancy,the incidence of threatened abortion,threatened premature labor,abnormal fetal position,intrauterine growth retardation（ IUGR）,premature rupture of membranes（ PROM） of observation group was higher than control group,the differences were statistically significant（ P〈0. 05）;but the incidence of the placenta previa and gestational diabetes mellitus（ GDM） between two groups was no significant difference（ P〈0. 05）. During childbirth,the incidence of cord around neck,low birth weight and premature birth of the observation group was higher than the control group,the differences were statistically significant（ P〈0. 05）; but the incidence of placental abruption,neonatal asphyxia,postpartum hemorrhage between two groups was no significant difference（ P〈0. 05）; observation group cesarean section rate was 71. 8%,higher than 52. 6% of the control group（ P〉0. 05）. 27 cases of caesarean birth removed uterus leiomyomas during the operation,in addition to operation time,there was no increased bleeding. Conclusion Uterine fibroids may increase the incidence of complications during pregnancy and childbirth,and cesarean section uterine myoma enucleation in parallel is feasible.