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目的观察腹腔镜辅助子宫肌瘤剔除术(LAM)患者的产科结局。方法比较有生育要求的LAM患者73例(L)组与同期开腹手术72例患者的产科结局。结果两组患者妊娠率、孕期并发症、肌瘤复发差异无统计学意义(P>0.05)。妊娠及分娩期均顺利,无子宫破裂发生,但剖宫产率较高,而产后出血量、围生儿的出生体重、出生后1分钟Apger评分以及新生儿病率等方面相似(P>0.05)。L组手术时间(45.9±16.7)min,盆腔粘连发生率30.4%(7/23),明显少于开腹组的(56.1±19.1)min和64.0%(16/25)(P<0.05)。结论LAM后妊娠是安全的,产科结局满意;但在妊娠及分娩期间应加强监护,适当放宽剖宫产指征。
Objective To observe the obstetric outcome of laparoscopic assisted myomectomy (LAM) patients. Methods The obstetric outcomes of 73 patients with LAM with reproductive requirements (L) and 72 patients with concurrent laparotomy were compared. Results There was no significant difference in pregnancy rate, pregnancy complications and fibroid recurrence between the two groups (P> 0.05). Pregnancy and childbirth were smooth without uterine rupture, but cesarean section rate was higher, and postpartum hemorrhage, perinatal birth weight, Apger score at 1 minute after birth and neonatal morbidity were similar (P> 0.05 ). The operative time (45.9 ± 16.7) min in L group and 30.4% (7/23) in pelvic adhesions were significantly lower than those in open group (56.1 ± 19.1) min and 64.0% (16/25) (P <0.05). Conclusions Pregnancy after LAM is safe and the obstetric outcome is satisfactory. However, care should be strengthened during pregnancy and childbirth, and cesarean indications should be appropriately relaxed.