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目的 探讨妊娠合并子宫肌瘤对妊娠期、分娩期及产褥期的影响以及剖宫产同时行肌瘤剔除术的可行性。方法 在孕早期、孕36周及产后3个月行B超检查分析肌瘤变化情况以及肌瘤对阴道分娩的影响,并对剖宫产同时行肌瘤剔除术时出血量和术后恢复进行观察和分析。结果 孕36周时43% (32 /74)病例肌瘤增大,肌瘤变性增多,妊娠合并症增多,剖宫产率增高。34例剖宫产同时行肌瘤剔除术,均成功剔除,出血量无明显增多。结论 妊娠能使部分肌瘤增大,直径超过6cm,子宫中下段肌瘤易致妊娠并发症,肌瘤直径在6cm以下阴道分娩较安全;剖宫产同时行肌瘤剔除术,当肌瘤孤立、数量不超过3个、非近子宫粘膜面时,则手术安全可行。
Objective To investigate the impact of pregnancy combined with uterine fibroids on gestational period, childbirth and the puerperium and cesarean section at the same time the feasibility of myomectomy. Methods In the first trimester of pregnancy, 36 weeks of gestation and 3 months postpartum, B-mode ultrasound examination was performed to analyze the changes of fibroids and the effect of fibroids on vaginal delivery. The amount of bleeding and postoperative recovery during concurrent cesarean section myomectomy Observation and analysis. Results At 36 weeks of gestation, 43% (32/74) cases of fibroids increased, myoma degeneration increased, pregnancy complications increased, cesarean section rate increased. 34 cases of cesarean section at the same time myomectomy, were successfully removed, no significant increase in bleeding. Conclusion Pregnancy can make some fibroids, diameter more than 6cm, lower uterine fibroids easily lead to complications of pregnancy, fibroids diameter less than 6cm vaginal delivery safer; cesarean section at the same time myomectomy, when fibroids isolated , The number does not exceed 3, non-uterine mucosal surface, the surgery safe and feasible.