妊娠合并子宫肌瘤患者分娩期剖宫产治疗的效果研究

Study on the effect of cesarean section during delivery in patients with pregnancy combined with hysteromyoma

目的探讨妊娠合并子宫肌瘤患者分娩期剖宫产治疗的效果研究。方法选取94例妊娠合并子宫肌瘤患者,按照随机数字表法分为观察组和对照组,每组47例。对照组使用剖宫产术,待患者身体恢复后再行子宫肌瘤剔除术,观察组同期行剖宫产及子宫肌瘤剔除术。比较两组患者手术及术后恢复指标、并发症发生情况、临床疗效及术后视觉模拟评分法(VAS)评分。结果观察组手术时间明显长于对照组,差异有统计学意义(P<0.05)。而两组术中出血量、术后阴道出血量、住院时间、新生儿阿普加(Apgar)评分、恶露完全排净时间、子宫复旧时间、月经恢复时间比较,差异均无统计学意义(P>0.05)。观察组尿潴留、产后出血、切口愈合不良、产褥期感染等并发症发生率与对照组比较,差异无统计学意义(P0.05)。观察组治疗总有效率为97.87%,明显高于对照组的78.72%,差异有统计学意义(P<0.05)。观察组术后6h、12h、24h的VAS评分均稍高于对照组,但差异均无统计学意义(P>0.05)。结论妊娠合并子宫肌瘤患者分娩期剖宫产治疗的效果显著,能一并清除肌瘤,避免了二次手术,且术后不影响子宫复旧,并发症也较少,也不会显著增加疼痛程度。

Objective To explore the effect of cesarean section in pregnancy complicated with uterine myoma.Methods 94 cases of pregnancy combined with uterine fibroids were selected and divided into the control group and the observation group according to the random number table method,47 cases in each group.The control group was treated with cesarean section,and then uterine myomectomy was performed until the patients recovered.The observation group was treated with cesarean section and uterine myomectomy at the same time.The surgical and postoperative recovery indicators,incidence of complications,clinical efficacy,and postoperative visual analogue scale(VAS)scores were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,the difference was statistically significant(P<0.05).However,there were no statistically significant differences between the two groups in the intraoperative bleeding volume,postoperative vaginal bleeding volume,hospital stay,neonatal Apgar score,complete elimination time of lochia,uterine rejuvenation time and menstrual recovery time(P>0.05).The incidence of complications such as urinary retention,postpartum hemorrhage,poor incision healing,and puerperium infection in the observation group was comparable to that in the control group(P>0.05).The treatment effective rate of the observation group was 97.87%,which was significantly higher than 78.72%of the control group,the difference was statistically significant(P<0.05).The visual analogue scale(VAS)scores of 6 h,12 h and 24 h after operation in the observation group were slightly higher than those in the control group,but the differences between the groups were not significant(P>0.05).Conclusion Cesarean section in pregnancy combined with uterine fibroids during delivery has a significant effect,which can remove the fbroids together and avoid the second operation.Moreover,it does not affect the uterine involution after operation,with less complications and no significant increase in the degree of pain.