产后子宫肌瘤剔除术后早期炎性肠梗阻一例  

A Case Report of Early Inflammatory Intestinal Obstruction after Postpartum Myomectomy

作　　者：陈燕芬[1] 卢如玲[2] 郑聪聪 曾蕾[2] 刘冠彤 谢琳玲 曾宇华 CHEN Yanfen;LU Ru-ling;ZHENG Cong-cong;ZENG Lei;LIU Guan-tong;XIE Lin-ling;ZENG Yu-hua(Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Gynaecology,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学,510405 [2]广州中医药大学第一附属医院妇科

出　　处：《国际生殖健康／计划生育杂志》2022年第1期25-29,共5页Journal of International Reproductive Health/Family Planning

基　　金：国家自然科学基金(81804135);2019年罗元恺滋肾育胎丸中青年科研基金项目(20190802)。

摘　　要：子宫肌瘤是育龄女性最常见的生殖系统良性肿瘤。妊娠合并子宫肌瘤是常见的妊娠合并症,属于产科高危妊娠的范畴。目前对于妊娠合并子宫肌瘤的管理仍存在一些争议。报告近期广州中医药大学第一附属医院妇科收治的1例妊娠合并肌壁间子宫肌瘤患者自然分娩后子宫肌瘤红色变性并发产褥感染,经腹式子宫肌瘤剔除术剔除病灶,同时并发术后早期炎性肠梗阻的病例诊治情况。手术病理证实为子宫平滑肌瘤伴红色变性及坏死,慢性化脓性子宫内膜炎;术中宫腔分泌物细菌培养结果为苛养颗粒链菌(Granulicatella elegans)。同时探讨子宫肌瘤妊娠前及妊娠期管理、妊娠合并子宫肌瘤红色变性及产褥期并发症如产褥感染、产后出血的处理策略,以及术后早期炎性肠梗阻的预防措施和诊治方案。Uterine fibroid is the most common benign tumors of female reproduction system of reproductive age.Pregnancy combined with hysteromyoma is a common pregnancy complication,which belongs to the category of high risk pregnancy.There are still some disputes about the management of pregnancy complicated with hysteromyoma.A complex case of postpartum uterine fibroid with red degeneration and puerperal infection after abdominal myomectomy,and combined with early postoperative inflammatory small bowel obstruction,was reported.Pathological diagnosis showed the hysteromyoma with red degeneration and necrosis,chronic suppurative endometritis.The culture of uterine secretions suggested the infection with Granulicatella elegans.Combined with this case report,we also review the management of hysteromyoma during prenatal and gestation period,the treatment strategies of pregnancy complicated with red degeneration of hysteromyoma and puerperal complications such as puerperal infection and postpartum hemorrhage,as well as the preventive measures,diagnosis and treatment of early postoperative inflammatory small bowel obstruction.

关 键 词：妊娠 子宫 肌瘤 产褥期感染 肠梗阻 病例报告 

分 类 号：R737.33[医药卫生—肿瘤] R574.2[医药卫生—临床医学]