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目的:观察剖宫产术中行子宫肌瘤剔除术的安全性及可行性。方法:将我院2010年1月-2012年1月入诊的90例子宫肌瘤的妊娠期孕妇,行剖宫产术同时行子宫肌瘤剔除术的患者,与同期83例单纯剖宫产手术患者对比研究,观察两种手术方式的临床疗效及其疾病预后分析。其主要比较的指标是平均手术时间、术中出血量、术后24h出血量、手术前后血红蛋白差值、平均住院时间、产褥病率及并发症等,记录并观察两组患者的上述指标,进行比较分析。结果:两组观察指标比较除剖宫产术中行子宫肌瘤剔除术平均手术时间(77.1±8.5)明显高于单纯剖宫产术(33.7±7.9),(t=34.70,P<0.05)外,其他各项测量术中出血量(t=0.09,P>0.05)、术后24h出血量(t=0.61,P>0.05)、手术前后血红蛋白差值(t=1.57,P>0.05)、住院时间(t=1.05,P>0.05)及产褥病率(x2=0.077,P>0.05),其他并发症发生率(x2=0.246,P>0.05)指标均无明显差异(P>0.05)。结论:对于有手术适应症的妊娠期子宫肌瘤孕妇,可根据患者及其家属医院选择剖宫产术同时行子宫肌瘤剔除术,该手术安全可靠,能避免二次手术或子宫切除等,临床上值得推广应用。
Objective: To observe the safety and feasibility of myomectomy in cesarean section. Methods: 90 cases of pregnant women with uterine fibroids admitted from January 2010 to January 2012 in our hospital underwent cesarean section with myomectomy at the same time, with 83 cases of simple cesarean section Surgical patients were compared to observe the clinical efficacy of two surgical methods and prognosis of the disease. The main indexes of the comparison were the average operation time, intraoperative blood loss, 24h postoperative blood loss, hemoglobin difference before and after surgery, average length of stay, puerperal morbidity and complications. The above indexes were recorded and observed in two groups of patients, For comparative analysis. Results: The mean operative time (77.1 ± 8.5) in cesarean section excluding cesarean section was significantly higher than that in simple cesarean section (33.7 ± 7.9) (t = 34.70, P <0.05) (T = 0.09, P> 0.05), blood loss after operation (t = 0.61, P> 0.05), hemoglobin difference before and after operation (t = 1.57, P> 0.05) There was no significant difference in the incidence of other complication (x2 = 0.246, P> 0.05) between the two groups in time (t = 1.05, P> 0.05) and puerperal morbidity (x2 = 0.077, P> 0.05). Conclusion: Pregnant women with gestational uterine fibroids with surgical indications can choose cesarean section according to patients and their relatives hospital at the same time the myomectomy, the operation is safe and reliable, to avoid secondary surgery or hysterectomy, etc., Clinically worth promoting application.