剖宫产同时切除子宫肌瘤75例临床分析

Clinical analysis of uterine-incision delivery with hysteromyomectomy in 75 cases

目的 探讨剖宫产术中同时行子宫肌瘤切除术的可行性。方法 回顾性分析解放军第91中心医院2013~2014年剖宫产术中同时行子宫肌瘤切除术75例患者的临床资料。将肌瘤直径≥4 cm的23例设为观察组,肌瘤直径〈4 cm的52例设为对照组,比较两组手术时间,术中出血量,平均住院日,恶露干净时间。结果 观察组手术时间[（55.35±13.06）min]长于对照组[（43.33±12.52）min]（P〈0.05）;术中出血量分别为[（281.32±51.13）m L、（280.35±51.26）m L]、平均住院日分别为[（5.25±1.81）d、（5.23±1.63）d]、恶露干净时间分别为[（35.28±1.78）d、（35.32±1.81）d],两组比较差异均无统计学意义（P〉0.05）。结论 妊娠合并子宫肌瘤的患者,病情平稳,剖宫产术中宫缩良好,剖宫产同时行肌瘤切除术是安全可行的。

Objective To explore the feasibility of uterine - incision delivery with hysteromyomectomy. Methods Clinical data of 75 cases of uterine- incision delivery with hysteromyomectomy in The 91th Hospital of PLA from 2013 to 2015 were retrospectively analyzed. Two groups were divided on the basis of hysteromyoma size, 23 cases whose hysteromyoma size ≥4 cm were selected into the observation group; 52 cases whose hysteromyoma size 〈 4cm were selected into the control group. The operation time, amount of bleeding, the average hospital stay, lochia time of postoperative of two groups were compared. Results The operation time of observation group [ （55.35 ± 13.06） min] was longer than that of the control group [ （43.33 ± 12. 52） min] （ P 〈 0.05 ）, the amount of bleeding [ （ 281.32 ± 51.13 ） mL, （ 280. 35 ± 51.26 ） mL respectively ], the average hospitalization days [ （ 5. 25 ± 1.81 ） mL, （ 5.23 ± 1.63） d respectively], time of lochia[ （35.28 ± 1.78 ）d, （35. 32± 1.81 ）d, respectively] had no significant difference between two groups. Conclusion Pregnancy with hysteromyoma whose uterine contraction is good in operation, condition stabilizes, uterine -incision delivery with hysteromyomectomy is safe and feasible.