目的:探讨剖宫产术中经子宫内膜入路切除子宫肌瘤的临床疗效及安全性。方法:回顾性分析2016年6月至2019年6月于福建省妇幼保健院剖宫产术中同时切除子宫肌瘤的200例患者的临床资料,依据其所行手术类型,其中102例经子宫内膜入路切除子宫...目的:探讨剖宫产术中经子宫内膜入路切除子宫肌瘤的临床疗效及安全性。方法:回顾性分析2016年6月至2019年6月于福建省妇幼保健院剖宫产术中同时切除子宫肌瘤的200例患者的临床资料,依据其所行手术类型,其中102例经子宫内膜入路切除子宫肌瘤(EM)为EM组,98例经子宫浆膜切除子宫肌瘤(SM)为SM组,比较两组围手术期相关指标(切除肌瘤时间、总手术时间,术中出血量术后血红蛋白改变值、术后肛门排气时间等)以评估新术式的疗效及安全性。结果;两组患者年龄、体质量指数(BMI)、孕次、产次,剖宫产指征,肌瘤特征(大小,数目,分型)相比较,差异无统计学意义(P>0.05)。EM组切除肌瘤时间小于SM组(12.80±3.95 min vs 15.55±3.75 min),术中出血量少于SM组(440.20±135.29 ml vs 510.82±183.44 ml)手术前后血红蛋白改变值小于SM组(14.63±3.85 g/Lvs 18.31±4.26 g/L),术后肛门排气时间小于SM组(19.33±0.577小时vs 22.80±1.643小时),差异均有统计学意义(P<0.05)。结论:剖宫产术中应用经子宫内膜入路切除子宫肌瘤安全,具有出血少、手术时间短等优势,可作为剖宫产同期行子宫肌瘤切除的常规方法之一进行推广应用。展开更多
Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous ca...Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.展开更多
文摘目的:探讨剖宫产术中经子宫内膜入路切除子宫肌瘤的临床疗效及安全性。方法:回顾性分析2016年6月至2019年6月于福建省妇幼保健院剖宫产术中同时切除子宫肌瘤的200例患者的临床资料,依据其所行手术类型,其中102例经子宫内膜入路切除子宫肌瘤(EM)为EM组,98例经子宫浆膜切除子宫肌瘤(SM)为SM组,比较两组围手术期相关指标(切除肌瘤时间、总手术时间,术中出血量术后血红蛋白改变值、术后肛门排气时间等)以评估新术式的疗效及安全性。结果;两组患者年龄、体质量指数(BMI)、孕次、产次,剖宫产指征,肌瘤特征(大小,数目,分型)相比较,差异无统计学意义(P>0.05)。EM组切除肌瘤时间小于SM组(12.80±3.95 min vs 15.55±3.75 min),术中出血量少于SM组(440.20±135.29 ml vs 510.82±183.44 ml)手术前后血红蛋白改变值小于SM组(14.63±3.85 g/Lvs 18.31±4.26 g/L),术后肛门排气时间小于SM组(19.33±0.577小时vs 22.80±1.643小时),差异均有统计学意义(P<0.05)。结论:剖宫产术中应用经子宫内膜入路切除子宫肌瘤安全,具有出血少、手术时间短等优势,可作为剖宫产同期行子宫肌瘤切除的常规方法之一进行推广应用。
基金Supported by Beijing Clinical Study(Z111107058811025)Beijing Government Excellent Person Sponsor Program
文摘Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.
