剖宫产术中经子宫内膜入路切除子宫肌瘤的效果研究  

Efficacy Analysis of Endometrial Myomectomy During Cesarean Section

作　　者：戴燕[1] 王琪 林金孝[1] DAI Yan;WANG Qi;LIN Jinxiao(Department of Obstetrics,Fujian Maternal and Child Health Care Hospital,Fuzhou Fujian 350001,China)

机构地区：[1]福建省妇幼保健院产科,福建福州350001

出　　处：《实用妇产科杂志》2022年第2期125-128,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨剖宫产术中经子宫内膜入路切除子宫肌瘤的临床疗效及安全性。方法:回顾性分析2016年6月至2019年6月于福建省妇幼保健院剖宫产术中同时切除子宫肌瘤的200例患者的临床资料,依据其所行手术类型,其中102例经子宫内膜入路切除子宫肌瘤(EM)为EM组,98例经子宫浆膜切除子宫肌瘤(SM)为SM组,比较两组围手术期相关指标(切除肌瘤时间、总手术时间,术中出血量术后血红蛋白改变值、术后肛门排气时间等)以评估新术式的疗效及安全性。结果;两组患者年龄、体质量指数(BMI)、孕次、产次,剖宫产指征,肌瘤特征(大小,数目,分型)相比较,差异无统计学意义(P>0.05)。EM组切除肌瘤时间小于SM组(12.80±3.95 min vs 15.55±3.75 min),术中出血量少于SM组(440.20±135.29 ml vs 510.82±183.44 ml)手术前后血红蛋白改变值小于SM组(14.63±3.85 g/Lvs 18.31±4.26 g/L),术后肛门排气时间小于SM组(19.33±0.577小时vs 22.80±1.643小时),差异均有统计学意义(P<0.05)。结论:剖宫产术中应用经子宫内膜入路切除子宫肌瘤安全,具有出血少、手术时间短等优势,可作为剖宫产同期行子宫肌瘤切除的常规方法之一进行推广应用。Objective:To investigate the clinical efficacy and safety of endometrial myomectomy in cesarean section.Methods:Clinical data of 200 patients who underwent simultaneous myomectomy during cesarean section in Fujian Maternal and Child Health Care Hospital from Jun.2016 to Jun.2019 were retrospectively analyzed.Patients were divided into two groups depending on the surgical style.102 patients who underwent endometrial myomectomy were divided into the endometrial myomectomy(EM)group, and 98 patients who underwent serosal myomectomy were divided into the serosal myomectomy(SM)group.The perioperative related indicators(operative time, intraoperative blood loss, pre-and post-operative hemoglobin drop, postoperative exhaust time)were compared between the two groups.Results:There were no significant differences in age, BMI,gravidity, parity, indications of cesarean section and fibroid characteristics(size, number and classification)between the two groups(P>0.05).The time of myoma removal in EM group was shorter than that in SM group(12.80±3.95 min vs.15.55±3.75 min),the inteaoperative blood loss was less than that of the SM group(440.20±135.29 ml vs. 510.82±183.44 ml).The pre-and post-operative hemoglobin drop was less than that of the SM group(14.63±3.85 g/L vs.18.31±4.26 g/L),and the postoperative exhaust time was less than that of the SM group(19.33±0.577 hour vs. 22.80±1.643 hour),the differences were statistically significant(P<0.05).Conclusions:The application of endometrial myomectomy during cesarean section is safe and effective, withadvantages of less bleeding and shorter operation time.It can be used as one of the conventional methods of myomectomy during cesarean section.

关 键 词：剖宫产子宫肌瘤切除 经子宫内膜入路切除子宫肌瘤 经子宫浆膜切除子宫肌瘤 

分 类 号：R737.33[医药卫生—肿瘤]