摘要
目的探讨不同类型的妊娠合并子宫肌瘤孕妇剖宫产术同时行子宫肌瘤剔除的临床结局。方法回顾性分析剖宫产分娩同时行子宫肌瘤剔除的孕妇246例,根据子宫肌瘤类型不同分为浆膜下子宫肌瘤组(135例)和肌壁间子宫肌瘤组(111例),分析其临床特征和结局。结果①肌壁间子宫肌瘤组中,孕妇年龄、子宫肌瘤≥5 cm的比例和多发子宫肌瘤的比例均明显高于浆膜下子宫肌瘤组(37岁vs 34岁,χ^(2)=-3.640,P=0.000;50.5%vs 25.9%,χ^(2)=15.719,P=0.000;55.0%vs 23.0%,χ^(2)=26.630,P=0.000)。②肌壁间子宫肌瘤组的手术时间以及常规应用缩宫素20 U的基础上额外应用缩宫素的比例明显高于浆膜下子宫肌瘤组(50 min vs 45 min,Z=-3.349,P=0.001;49.5%vs 29.6%,χ^(2)=10.197,P=0.001),产后出血≥500 mL的比例和出血量也明显增加(47.7%vs 33.3%,χ^(2)=5.281,P=0.022;530 mL vs 400 mL,Z=-3.247,P=0.001)。结论剖宫产术中行肌壁间子宫肌瘤剔除额外应用缩宫素的比例和出血量均明显增加,但不增加严重产后出血风险。
Objective To explore the clinical outcomes of cesarean myomectomy(CM)in pregnant women with different types of uterine myomas.Methods A retrospective cohort study of 246 singleton pregnancies with different types of uterine myomas underwent cesarean section and CM was performed.There were subserosal myomas(SM)group(135 cases)and intramural myomas(IM)group(111 cases)according to the different types of uterine myomas.The clinical characteristics and delivery outcomes were analyzed.Results①In IM group,the maternal age,the proportion of myomas(≥5 cm)and the proportion of multiple myomas were significantly higher than those in SM group(37 years vs 34 years,χ^(2)=-3.640,P=0.000;50.5%vs 25.9%,χ^(2)=15.719,P=0.000;55.0%vs 23.0%,χ^(2)=26.630,P=0.000).②In IM group,the operation time and the proportion of using additional oxytocin were higher than those in SM group significantly(50 min vs 45 min,Z=-3.349,P=0.001;49.5%vs 29.6%,χ^(2)=10.197,P=0.001).In IM group,blood loss≥500 mL and the blood loss increased significantly than that in SM group(47.7%vs 33.3%,χ^(2)=5.281,P=0.022;530 mL vs 400 mL,Z=-3.247,P=0.001).Conclusion The proportion of using additional oxytocin and blood loss increased in CM in singleton pregnant women with intramural myomas,but the risk of severe postpartum hemorrhage(PPH)did not increase.
作者
路畅
胡江涛
李金皎
姜海利
Lu Chang;Hu Jiangtao;Li Jinjiao;Jiang Haili(Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China;Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China)
出处
《首都医科大学学报》
CAS
北大核心
2022年第4期653-657,共5页
Journal of Capital Medical University
作者简介
Corresponding author:姜海利,E-mail:jianghaili2020@ccmu.edu.cn。
