Clinical and Therapeutic Aspects of Giant Fibroids at the Hôpital du Mali about 30 Cases

The fibroids affect 20% to 25% of women of reproductive age and are 3 to 9 times more common in black women. We’ll talk about giant fibroids (GFs) when uterine height reaches or exceeds the navel. We have initiated this study in order to report the epidemioclinical and therapeutic aspects of giant fibroids at the Hopital du Mali. A descriptive retro-prospective study, conducted in the service of gynecology of the Hopital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterin e height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25 - 29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. The uterine height was between 25 and 29 cm on physical examination in 46.66% of cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3% of cases. The size of the nuclei after surgery was over 25 cm in 48.66% of our patients. Conclusion: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and depends on the indications.

MEWS系统在指导院前急性脑血管意外急救的临床应用

目的探讨应用改良早期预警(MEWS)评分指导急性脑血管意外院前急救的临床价值。方法将院前急救中临床诊断为急性脑血管意外的患者分为常规病情评估急救组(对照组)和进行现场MEWS评分指导急救组(实验组),并比较两组患者的病死率及好转出院率。结果对照组病死率为17.23%,好转出院率为82.77%;实验组病死率为8.76%,好转出院率为91.24%。两组比较,差异有统计学意义(P<0.05)。结论急性脑血管意外患者院前应用MEWS评分进行病情评估和指导急救,能降低患者的病死率及提高好转出院率,具有较好的应用价值,值得在院前脑血管意外急救中推广应用。