妊娠合并子宫肌瘤在剖宫产术中的可行性研究(1)
 |
| 第1页 |
参见附件。
[摘要] 目的 评价妊娠合并子宫肌瘤在剖宫产术中的可行性。方法 选取2009年1月～2011年1月我院收治的妊娠合并子宫肌瘤患者50例设立为观察组，另选择同期住院的未合并子宫肌瘤行剖宫产的产妇50例作为对照组。 结果 两组均顺利完成手术，两组术后体温均恢复正常，无产褥感染发生。观察组的手术用时长，术中出血量多，但两组住院时间差异不显著；术中观察组应用缩宫素的量明显多于对照组，术后两组缩宫素用量比较差异不显著(P <0.05)。结论 妊娠合并子宫肌瘤在剖宫产术中是可行的，值得予以推广和应用。
[关键词] 子宫肌瘤；妊娠；合并；剖宫产；可行性
[中图分类号] R719.8 [文献标识码] B [文章编号] 1673-9701(2012)04-0058-02
Feasibility study of cesarean section on pregnant women with uterine fibroids
XUAN Zhangbiao JIANG Xiaodi
Department of Gynaecology, Zhuji Maternity and Child Care Hospital of Zhejiang Province, Zhuji 311800, China
[Abstract] Objective To evaluate the pregnancy with uterine fibroids in the feasibility of cesarean section. Methods All of 50 pregnancy patients with uterine fibroids as the observation group were selected from January 2009 to January 2011 in our hospital. The other did not choose the same period in hospital cesarean section with uterine fibroids 50 maternal cases as the control group. Results Both groups were successfully completed surgery, and postoperative body temperature returned to normal time, and no puerperal infection. Surgical duration, blood loss of observation group was more, and there were no significant differences in length of stay. Intraoperative oxytocin received in observe group was significantly more than the control group, and after operation two groups of oxytocin is not significant (P < 0.05). Conclusion Pregnancy in a cesarean section with uterine fibroids is feasible, should be promoted and applied.
[Key words] Uterine fibroids; Pregnancy; Merger; Cesarean section; Feasibility
妊娠合并子宫肌瘤是临床上较为常见的妊娠并发症，文献报道，妊娠合并子宫肌瘤的发病率占肌瘤患者的0.5%～1.0%，占妊娠的0.3%～0.5%[1]。目前国内外多项研究倾向于剖宫产术的同时行子宫肌瘤剔除，尤其是妊娠后期肌瘤变性明显增多，有必要在剖宫产同时剔除肌瘤。本研究旨在评价妊娠合并子宫肌瘤在剖宫产术中的可行性，现报道如下。
1 资料与方法
1.1 一般资料
选取2009年1月～2011年1月我院收治的妊娠合并子宫肌瘤患者50例设立为观察组，年龄22～40岁。肌瘤类型：肌壁间肌瘤24例，浆膜下肌瘤16例，黏膜下肌瘤8例，子宫颈肌瘤2例；另选择同期住院的未合并子宫肌瘤行剖宫产的产妇50例作为对照组，两组的年龄、孕周等临床基本资料比较，差异不显著(P > 0.05)，具有可比性。见表1。
1.2 手术方法
硬膜外麻醉，对照组常规行腹膜内子宫下段剖宫产术，观察组在娩出胎儿及胎盘后，将子宫提出腹腔，于肌瘤基底部及其周围多点注射缩宫素20 U+生理盐水稀释至20 mL。前、后壁肌瘤位于宫体上部者选择横切口，肌瘤直径>5 cm在肌瘤表面做一棱形切口，切口大小接近肌瘤长度，深达肌核，并见核外假包膜，用2根鼠齿钳钳夹肌瘤切口边缘，向外牵拉暴露肌瘤，用刀柄快速钝性剥下肌瘤，剥至基底时，尽量不进入宫壁，用0～0 Dexson线从基底部时尽量不进入官腔并按瘤腔大小缝12层，缝至子宫浆膜层改用0～0可吸收线小平褥式连续缝合包埋粗糙面，术后予以缩宫素及抗生素预防感染，并观察术后出血量。
1.3 观察指标
观察比较两组在手术时间、术中出血量、住院时间、产褥感染等并发症方面的差异性 ......
您现在查看是摘要介绍页，详见PDF附件(1936kb)。