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目的 探讨剖宫产术时剔除肌瘤的指征和方法。方法 对 76例妊娠合并子宫肌瘤行剖宫产术患者进行回顾性分析。结果 剖宫产同时行肌瘤剔除 6 7例 ,无 1例行全子宫切除术。直径≤ 5cm的肌壁间肌瘤和浆膜下肌瘤 ,多发肌瘤剔除时手术失血量、产后子宫复旧及产褥感染率与非剔除组相比 ,差异无显著性。结论 行剖宫产术时应尽量同时剔除肌瘤 ,以免受二次手术的痛苦 ,同时采用半荷包连续缝合的方式关闭瘤腔 ,以减少出血及术后并发症。而对于在血管丰富部位和难以暴露部位的肌瘤如宫角肌瘤 ,韧带肌瘤 ,直肠窝的子宫下段肌瘤 ,则由于止血困难 ,手术危险性大 ,不主张在剖宫产时剔除
Objective To investigate the indications and methods of removing fibroids during cesarean section. Methods 76 cases of cesarean pregnancy with uterine fibroids were retrospectively analyzed. Results Caesarean section at the same time myomectomy 6 7 cases, no routine hysterectomy. There was no significant difference in intramural fibroids and subserosal fibroids less than 5 cm in diameter, surgical blood loss in patients with multiple myoma excisions, postpartum uterine involution and puerperal infection rates. Conclusions Cesarean section should try its best to remove fibroids at the same time to avoid the pain of secondary surgery. At the same time, the tumor cavity should be closed by semi-pouch continuous suture to reduce the bleeding and postoperative complications. As for the rich parts of the blood vessels and difficult to expose the site of fibroids such as fibroids, ligament fibroids, rectal fossa of the lower uterine fibroids, due to hemostasis, the risk of surgery, does not advocate the removal of cesarean section