妊娠合并子宫肌瘤术中临床分析
Clinical Analysis of Pregnancy Complicated with Uterine Myoma in Caesarian Operation
目的 探讨晚期妊娠合并子宫肌瘤术中处理方法.方法 妊娠晚期合并子宫肌瘤68例,并按肌瘤大小、肌瘤类型进行分组,对术中出血量、手术时间及住院天数进行比较.结果 剖宫产术前诊断妊娠合并子宫肌瘤37例,剖宫产加子宫肌瘤剔除术术中出血量、手术时间和住院天数与单纯剖宫产相比较差异无统计学意义(P>0.05);妊娠合并宫体肌瘤组手术时间较妊娠合并子宫下段及宫颈部肌瘤组手术时间明显缩短(P<0.05);>8 cm肌瘤组与≤8 cm肌瘤组相比较,手术时间明显延长,术中出血量显著增多(P<0.05);黏膜下肌瘤组的手术时间、术中出血量和术后住院天数均较浆膜下肌瘤组显著延长(P<0.05).结论 对于妊娠合并子宫肌瘤患者,需尽早明确诊断,并根据肌瘤大小、部位和患者情况以决定分娩方式和术中处理方法.对肌瘤直径>8 cm、子宫下段肌瘤、宫颈部肌瘤及黏膜下肌瘤的处理应谨慎.
更多Objective To investigate the treatment of third trimester pregnancy complicated with uterine myoma. Methods 68 cases of third trimester pregnancy complicated with uterine myoma were livided into groups according to the size and subtype of myoma. Blood loss, operation hours and postoperative inpatient period were compared. Results 37 cases of pregnancy complicated with uterine myoma were diagnosed before caesarian operation no significant differences on blood losses and operation hours were found between caesarian operation group and myoma caesarian operation group( P > 0. 05 ). The operation hours of myoma in corpus uterine was significantly shorter than myoma in lower uterine segment and cervix (P <0. 05) ;Myoma( >8 cm) needed significantly longer operative hours and lose more blood than the myoma( ≤8 cm). Operation hours,blood lose and postoperative inpatient period were significantly different between submucous myoma and subserous myoma ( P < 0. 05 ). Conclusion Pregnancy complicated with uterine myoma should be diagnosed as early as possible. During caesarian operation on when myoma was bigger than 8 cm, Locating at lower uterine segment or cervix or submucous, the treatment should be cautious.
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