Effect of simultaneous application of cesarean section and myomectomy for pregnant women with hysteromyoma
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摘要:目的 探讨妊娠合并子宫肌瘤患者同期行剖宫产术和子宫肌瘤剔除术的临床效果。方法 选取80例妊娠合并子宫肌瘤患者，采用计算机随机分组法分为对照组和观察组，各40例。对照组孕妇分娩时行单纯剖宫产术，术后择期切除肌瘤，观察组孕妇剖宫产术同期行子宫肌瘤剔除术，比较2组孕妇围术期临床指标、产后并发症及新生儿健康状况。结果 2组均成功完成手术，观察组术中无1例发生大出血。观察组手术时间显著长于对照组(P < 0.05), 但2组间术中出血量、术后1 d视觉模拟评分法(VAS)评分、肛门排气时间和住院时间无显著差异(P>0.05); 2组产妇产后出血量、恶露持续时间、月经恢复时间和产褥感染率、切口感染率比较，差异均无统计学意义(P>0.05); 2组新生儿出生体质量、身长、5 min Apgar评分及新生儿窒息率比较，差异无统计学意义(P>0.05)。结论 妊娠合并子宫肌瘤患者同期行剖宫产术和子宫肌瘤剔除术是安全可行的，不影响母婴健康，且避免了二次手术创伤。Abstract:Objective To investigate the clinical efficacy of cesarean section and myomectomy for pregnant women with uterine leiomyoma.Methods A total of 80 pregnant women with uterine leiomyoma admitted to our hospital were randomly divided into control group(n=40) and observation group(n=40) by computer. The control group received cesarean section alone when delivery, and underwent selective surgery for hysteromyoma resection. The observation group received hysteromyomectomy during the same period of cesarean section. The perioperative clinical indicators, postpartum complications and neonatal health status were compared between the two groups.Results The surgeries were successfully completed in both groups, and no massive hemorrhage occurred in the observation group. The operation time of the observation group was significantly longer than that of the control group (P < 0.05), but there were no significant differences in intraoperative bleeding volume, Visual Analogue Scale(VAS) score after 1 d of operation, anal exhaust time and hospitalization time between the two groups (P > 0.05); no significant differences in postoperative bleeding volume, duration of lochia, menstrual recovery time, incidences of puerperal infection and incision infection betweenthe two groups were observed(P > 0.05); there were no significant differences in body weight at birth, body length, 5 min Apgar score and neonatal asphyxia rate (P > 0.05).Conclusion Cesarean section and myomectomy are safe and feasible for pregnant women with uterine leiomyoma, which has no impact on the health of puerperas and infants and can avoid trauma caused by secondary surgery.
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Keywords:
- pregnancy /
- hysteromyoma /
- cesarean section /
- myomectomy /
- delivery outcomes /
- feasibility
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表 1 2组围术期临床指标比较(x±s)
组别 n 手术时间/min 术中出血量/mL 术后1 d VAS评分/分 肛门排气时间/h 住院时间/d 对照组 40 48.28±10.36 213.60±59.25 5.37±1.73 38.53±10.68 6.16±1.03 观察组 40 72.30±12.59* 224.07±62.38 5.40±1.75 39.14±12.40 6.20±1.15 与对照组比较, *P < 0.05。 
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表 2 2组产妇产后恢复情况比较(x±s)[n(%)]
组别 n 产后出血量/mL 恶露持续时间/周 月经恢复时间/周 产后并发症 产褥感染 切口感染 对照组 40 231.10±58.24 2.82±0.31 6.75±1.98 4(10.00) 1(2.50) 观察组 40 210.24±61.35 2.81±0.29 6.80±2.03 1(2.50) 2(5.00)
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表 3 2组新生儿健康状况比较(x±s)[n(%)]
组别 n 身长/cm 体质量/g 5 min Apgar评分/分 新生儿窒息 对照组 40 48.31±2.25 3 359.16±324.57 9.16±0.74 2(5.00) 观察组 40 48.29±2.30 3 346.93±330.25 9.20±0.51 1(2.50)
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[1] 徐桂强, 吴静, 申丽君, 等. 子宫肌瘤发生风险关系的研究[J]. 中国妇幼保健, 2015, 30(29): 5019-5023. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201529039.htm [2] 闫震. 妊娠与子宫肌瘤相关的几个问题[J]. 中国临床医生杂志, 2016, 44(6): 1-3. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYS201606002.htm [3] 雷志萍, 代明月, 肖雪梅, 等. 精细化护理在剖宫产术同时行子宫肌瘤剔除术患者中的应用效果[J]. 实用临床医药杂志, 2017, 21(2): 111-113. doi: 10.7619/jcmp.201702035 [4] 夏晓梦, 方小玲. 子宫肌瘤手术的相关策略与妊娠结局[J]. 实用妇产科杂志, 2017, 33(4): 254-256. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201704007.htm [5] Prusinski Fernung L E, Jones K, Mas A, et al. Expanding upon the human myometrial stem cell hypothesis and the role of race, hormones, age, and parity in a profibroid environment[J]. Am J Pathol, 2018, 188(10): 2293-2306. doi: 10.1016/j.ajpath.2018.06.023
[6] 李伊莎, 陈璐, 刘丹, 等. 加减平积汤对子宫肌瘤患者雌、孕激素受体, 性激素、胰岛素生长因子-Ⅰ及其受体水平的影响[J]. 海南医学院学报, 2017, 23(21): 2945-2948. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYY201721013.htm [7] 王红梅, 代荫梅. 子宫肌瘤对妊娠并发症的影响[J]. 中国妇产科临床杂志, 2016, 17(1): 86-89. https://www.cnki.com.cn/Article/CJFDTOTAL-FKLC201601035.htm [8] Yazawa H, Takiguchi K, Ito F, et al. Uterine rupture at 33rd week of gestation after laparoscopic myomectomy with signs of fetal distress. A case report and review of literature[J]. Taiwan J Obstet Gynecol, 2018, 57(2): 304-310. doi: 10.1016/j.tjog.2018.02.022
[9] 王娜. 妊娠合并子宫肌瘤剖宫产时处理方法分析[J]. 中华肿瘤防治杂志, 2018, 25(S1): 140-140, 142. https://www.cnki.com.cn/Article/CJFDTOTAL-QLZL2018S1087.htm [10] 程佳. 剖宫产同时行子宫肌瘤切除术的手术方法及效果[J]. 中国计划生育和妇产科, 2017, 9(8): 50-52, 56. https://www.cnki.com.cn/Article/CJFDTOTAL-JHFC201708014.htm [11] 罗腾飞. 妊娠合并子宫肌瘤行剖宫产术中肿瘤剔除的临床疗效探究[J]. 中华肿瘤防治杂志, 2018, 25(S1): 141-142. https://www.cnki.com.cn/Article/CJFDTOTAL-QLZL2018S1088.htm [12] 吴聪哲, 张英欣, 赵欣, 等. 腹腔镜子宫肌瘤剔除术中缩宫素不同用药方法的止血疗效分析[J]. 中国综合临床, 2018, 34(2): 118-121. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXJH201811023.htm [13] 徐婉妍, 徐小凤, 麦今宝, 等. 棒球式缝合止血法在妊娠合并子宫肌瘤剔除术中的临床应用[J]. 中国妇幼保健, 2017, 32(6): 1145-1147. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201706010.htm [14] 叶青, 朱爱华, 吴珊. 剖宫产术同期子宫肌瘤剔除对围生期指标和术后恢复情况的影响[J]. 中国医师杂志, 2018, 20(3): 448-450. [15] 王新力, 朱艳, 龚英英. 剖宫产同期行子宫肌瘤切除术疗效及安全性观察[J]. 贵州医药, 2018, 42(9): 1099-1101. https://www.cnki.com.cn/Article/CJFDTOTAL-GZYI201809029.htm -
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