剖宫产同时行子宫肌瘤切除术420例分析

目的:探讨剖宫产同时行子宫肌瘤切除术是否可导致产时和产后短期内发病率的增加。方法:电脑检索本院1999年1月～2004年12月病历资料,妊娠合并子宫肌瘤孕妇在剖宫产的同时行子宫肌瘤切除术共有420例,单纯行剖宫产的有335例,比较两组手术前、后的血色素改变、手术时间、产后住院时间、产后发热率和出血率。结果:肌瘤切除组出血率高于单纯剖宫产组(P<0.01),但在产后发热率、手术时间和产后住院时间方面两组比较无显著差异。结论:恰当选择病例并由有经验的手术医生进行手术,剖宫产同时行子宫肌瘤切除术是一种安全的手术方法。

A retrospective analysis of 420 women with myomectomy at time of cesarean delivery

Objective:To analyze whether myomectomy at time of cesarean delivery leads to an increased incidence of intrapartum and short-term postpartum complications.Methods:A computer search of medical records from January 1999 to December 2004 identified a total of 420 women who underwent myomectomy at time of cesarean delivery and 355 women with documented fibroids during the index pregnancy who underwent cesarean delivery alone.Charts were reviewed for the following outcome variables: change in hematocrit from preoperative to postoperative period, length of operation, length of postpartum stay, incidence of postpartum fever, and incidence of hemorrhage.Results:The incidence of hemorrhage in the study group was 16.4% as compared with 8.7% in the control group (P<0.01).There was no statistically significant increase in the incidence of postpartum fever, operating time, and length of postpartum stay.Conclusion:In selected patients, myomectomy during cesarean delivery appears to be a safe procedure by experienced doctors.