宫剖产术中行子宫肌瘤剔除术疗效分析

目的探讨在剖宫产术中行子宫肌瘤剔除的可行性。方法回顾性分析208例妊娠合并子宫肌瘤患者,其中108例为行剖宫产及子宫肌瘤剔除术组（CM=caesarean section and myomectomy）,100例为单纯行剖宫产术组即非剔除术组（NCM=caesarean section with nomyomectomy）,按单个瘤体最大直径分三个层次（Φ〈5.0cm;5.0cm≤Φ〈8cm;Φ≥8cm）比较两组手术时间（OT=operation time length）、术中出血量（OBL=blood loss in operation）、恶露量（LW=the weight of lochia）、恶露持续时间（LT=lochia time length）等数据。结果①Φ〈5.0cm两组OT、OBL、LW、LT比较差异不显著（P〉0.05）;②5.0cm≤Φ〈8cm时UM组与NUM组比较OT、OBL增加,LW、LT减少,差异显著（P〈0.05）;③Φ≥8cmUMR组与NUMR组比较OT、OBL增加,LW、LT减少,差异显著（P〈0.05）。结论剖宫产术中行子宫肌瘤剔除虽有增加手术时间及出血量的可能,但可以促进产后子宫恢复并避免了二次手术痛苦,在患者病情许可下是安全可行的。

To analysis the therapeutic effect of myomectomy during the process of caesarean section

Objective To evaluate the feasibility of myomectomy during the process of caesarean section.Methods Retrospectively analysis of the total 208 cases suffered leiomyoma uteri during pregnancy,among these cases 108 patients were performed caesarean section and myomectomy （the group of CM）,while the other 100 patients were only performed caesarean section （the group of NCM）.According to the biggest size of the uterus myoma in every patient,these cases were separated to three levels（Φ〈5.0 cm; 5.0 cm≤Φ8 cm;Φ≥8 cm）.To compare the two groups＇ test data：the operation time length （OT）,the blood loss in operation （OBL）,the weight of lochia （LW）,the time length of lochia （LT）.Results The CM versus the NCM ①Φ〈5.0 cm The compare of OT and OBL ,LW and LT were statisticly no difference（P〉0.05）.② 5.0 cm≤Φ〈8 cm The results of OT and OBL increased,the LW and LT decreased in the group of UM comparing to NUM,the difference were statisticly significant（P〈0.05）.③Φ≥8 cm The results were just same as in the level of 5.0 cm≤Φ〈8 cm,the difference were statisticly significant（P〈0.05）.Conclusion Although there is the possibility of increasing operation time length and blood loss while performing myomectomy during the process of caesarean section,but it has the advantage of promoting involution of uterus and avoiding the pain of re-operation.So it is safe and feasible to perform myomectomy during the process of caesarean section.