剖宫产术中切除子宫肌瘤的疗效评价  

Evaluation of the efficacy of removing uterine fibroids during cesarean section

作　　者：戴巧红 陈安儿[1] DAI Qiaohong;CHEN Aner(Department of Obstetrics and Gynecology,Ningbo Women and Children’s Hospital,Ningbo 315000,Zhejiang,China)

机构地区：[1]宁波市妇女儿童医院妇产科,浙江宁波315000

出　　处：《中国现代医生》2024年第3期10-12,共3页China Modern Doctor

基　　金：浙江省卫生健康科技计划项目(2022KY337);省市共建医学重点学科建设计划项目(2010-S04)。

摘　　要：目的 探讨剖宫产术中应用压脉带捆绑子宫下段阻断子宫血供联合多种缝合方式切除子宫肌瘤的疗效评价。方法选取2015—2020年宁波市妇女儿童医院收治的因瘢痕子宫行择期剖宫产术的产妇共260例,采用随机数字表法分为两组。研究组130例,剖宫产术中用压脉带捆绑子宫下段并行子宫肌瘤切除术;对照组130例,行单纯剖宫产术。通过查阅患者病历资料及电话回访,收集患者的一般资料、手术相关资料、术后恢复情况等,并进行对比分析。结果 研究组产妇手术时间长于对照组[(72.01±22.63)min vs.(58.78±11.64)min],术中出血量多于对照组[(543.52±294.79)ml vs.(412.46±98.49)ml],术后发热比例高于对照组(10.0%vs. 0.8%),术后住院时间长于对照组[(5.13±1.23)d vs.(4.47±0.72)d],差异有统计学意义(P<0.05)。研究组与对照组患者术后排气时间比较[(16.07±4.90)h vs.(16.14±4.93)h],差异无统计学意义(P>0.05)。两组均无再次手术及死亡病例,新生儿出生情况均良好。结论 剖宫产术中行压脉带捆绑子宫下段联合多种缝合方式切除子宫肌瘤,虽增加术中出血量、手术时间、术后发热概率、住院时间,但可帮助患者同时解决子宫肌瘤疾病,且未出现严重并发症。Objective To evaluate the therapeutic effect of removing uterine fibroids by binding the lower segment of uterus with pressure pulse band and blocking uterine blood supply combined with various suture methods during cesarean section.Methods A total of 260 cases of pregnant women undergoing elective cesarean section due to cicatricial uterus treated in Ningbo Women and Children’s Hospital from 2015 to 2020 were selected.They were divided into two groups using the random number table method.In study group of 130 cases,the lower section of the uterus was bound with compression vein band and uterine fibroids were removed during cesarean section.In control group,130 cases underwent pure cesarean section.Through consulting patients’medical records and telephone visits,the general data,operation related data and postoperative recovery data of patients were collected and compared.Results The operation time in study group was longer than that in control group[(72.01±22.63)min vs.(58.78±11.64)min],the amount of intraoperative blood loss was higher than that of control group[(543.52±294.79)ml vs.(412.46±98.49)ml],the proportion of postoperative fever was higher than that of control group(10.0%vs.0.8%),and the postoperative hospital stay was longer than that of control group[(5.13±1.23)d vs.(4.47±0.72)d],the difference was statistically significant(P<0.05),and there was no statistically significant difference in postoperative exhaust time[(16.07±4.90)h vs.(16.14±4.93)h],the difference was not statistically significant(P>0.05).There were no cases of re-operation or death in both groups,and the newborns were all in good condition.Conclusion In the course of cesarean section,binding the lower segment of the uterus with pressure pulse band combined with various suture methods to remove uterine fibroids,although increased intraoperative blood loss,operation time,postoperative fever incidence,hospital stay,but can help patients solve uterine fibroids disease at the same time,and without serious complications.

关 键 词：妊娠合并子宫肌瘤 剖宫产 压脉带 基底部钱包缝合 出血 

分 类 号：R719.8[医药卫生—妇产科学]