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目的探讨剖宫产术中同时行子宫肌瘤剔除术的可行性及安全性。方法回顾性分析我院2010年1月-2013年12月116例剖宫产术中子宫肌瘤剔除术患者的临床资料,与同期无子宫肌瘤仅行剖宫产术的116例患者进行对比,比较2组在手术时间、术中出血量、产后出血率、住院时间、术后感染率。结果观察组手术时间长于对照组(P<0.05)。观察组术中出血量多于对照组,产后出血率高于对照组,但差异无统计学意义(P>0.5)。2组住院时间、术后感染率差异无统计学意义(P>0.5)。观察组肌瘤剔除术过程中出血>500ml 3例,其中2例为宫角部子宫肌瘤,肌瘤直径分别为4cm和6cm。1例为黏膜下子宫肌瘤,肌瘤直径7cm。观察组切下组织术后病理均证实为:子宫平滑肌瘤。所有患者无1例行子宫全切术或次子宫全切术,均治愈出院。产后42d行子宫、双附件彩超检查,均未见明显异常。结论选择性在剖宫产术中同时行子宫肌瘤剔除术是安全可行的,可避免二次手术给患者带来的痛苦,同时亦减轻了患者的家庭经济负担。
Objective To investigate the feasibility and safety of simultaneous uterine myomectomy in cesarean section. Methods The clinical data of 116 patients with myomectomy in cesarean section from January 2010 to December 2013 in our hospital were retrospectively analyzed and compared with 116 patients who underwent cesarean section only without uterine fibroids The operation time, intraoperative blood loss, postpartum hemorrhage rate, hospitalization time and postoperative infection rate were compared between the two groups. Results The operation time of the observation group was longer than that of the control group (P <0.05). The bleeding volume in the observation group was more than that in the control group, and the postpartum hemorrhage rate was higher than that in the control group, but the difference was not statistically significant (P> 0.5). Two groups of hospitalization time, postoperative infection rate difference was not statistically significant (P> 0.5). Observation group myomectomy bleeding> 500ml in 3 cases, of which 2 cases of uterine fibroids uterine horn fibroids diameter were 4cm and 6cm. 1 case of submucosal uterine fibroids, myoma diameter 7cm. The observation group after resection of the tissue pathology were confirmed as: uterine leiomyoma. All patients without routine hysterectomy or subtotal hysterectomy were cured and discharged. Postpartum 42d line uterus, double attachment color Doppler ultrasound examination, no obvious abnormalities. Conclusion Selective ectopic myomectomy in myomectomy is safe and feasible, to avoid the pain caused by the second surgery to patients, but also reduce the financial burden on the family.