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目的探讨在剖宫产术中行子宫肌瘤剔除的可行性。方法回顾性分析208例妊娠合并子宫肌瘤患者,其中108例为行剖宫产及子宫肌瘤剔除术组(CM=caesarean section and myomectomy),100例为单纯行剖宫产术组即非剔除术组(NCM=caesarean section with nomyomectomy),按单个瘤体最大直径分三个层次(Φ<5.0cm;5.0cm≤Φ<8cm;Φ≥8cm)比较两组手术时间(OT=operation time length)、术中出血量(OBL=blood loss in operation)、恶露量(LW=the weight of lochia)、恶露持续时间(LT=lochia time length)等数据。结果①Φ<5.0cm两组OT、OBL、LW、LT比较差异不显著(P>0.05);②5.0cm≤Φ<8cm时UM组与NUM组比较OT、OBL增加,LW、LT减少,差异显著(P<0.05);③Φ≥8cmUMR组与NUMR组比较OT、OBL增加,LW、LT减少,差异显著(P<0.05)。结论剖宫产术中行子宫肌瘤剔除虽有增加手术时间及出血量的可能,但可以促进产后子宫恢复并避免了二次手术痛苦,在患者病情许可下是安全可行的。
Objective To investigate the feasibility of removing hysteromyoma in cesarean section. Methods A retrospective analysis of 208 cases of pregnancy with uterine fibroids, of which 108 cases of cesarean section and myomectomy (CM = caesarean section and myomectomy), 100 cases of simple cesarean section group that is not removed The operation time (OT) was compared between the three groups (Φ <5.0cm; 5.0cm≤Φ <8cm; Φ≥8cm) according to the maximum diameter of single tumor in the operation group (NCM = caesarean section with nomyomectomy) OBL = blood loss in operation, LW = the weight of lochia, lochia time length and other data. Results ① The OT, OBL, LW and LT were not significantly different between the two groups with Φ <5.0cm (P> 0.05). ② In the UM group and the NUM group, the OT and OBL increased and the LW and LT decreased (P <0.05). ③ Compared with NUMR group, the levels of OT and OBL increased and LW and LT decreased in ΦΦ8cmUMR group (P <0.05). Conclusion Cesarean removal of uterine fibroids may increase the operation time and bleeding volume, but it can promote postpartum uterine recovery and avoid the pain of secondary surgery, which is safe and feasible under the condition of patients.