CAJ | 학술논문

目的:探讨晚期妊娠合并子宫肌瘤术中处理方法.方法:回顾性分析2003年1月至2008年8月在本院治疗的193例晚期妊娠合并子宫肌瘤患者的临床资料,并按分娩方式、肌瘤大小、肌瘤类型进行分组,对其术中出血量、手术时间及术后住院天数进行比较.结果:剖宫产术前诊断妊娠合并子宫肌瘤104例,术前诊断率53.9%;剖宫产加子宫肌瘤剔除术术中出血量、手术时间和术后住院天数与单纯剖宫产相比差异无统计学意义(P>0.05);妊娠合并宫体肌瘤组手术时间较妊娠合并子宫下段及宫颈部肌瘤组明显缩短(P=0.007);>8 cm肌瘤组与≤2 cm肌瘤组、2～5 cm肌瘤组和>5～8 cm肌瘤组相比较,手术时间明显延长,术中出血量显著增多(P<0.05);黏膜下肌瘤组的手术时间、术中出血量和术后住院天数均较浆膜下肌瘤组显著延长(P<0.05).结论:对于妊娠合并子宫肌瘤患者,需尽早明确诊断,并根据子宫肌瘤的类型、位置及大小和患者的年龄及生育需求、有无其他严重妊娠合并症等综合考虑以决定分娩方式和术中处理方法.对直径>8cm的肌瘤、子宫下段及宫颈部肌瘤、黏膜下肌瘤的处理应谨慎.
목적:탐토만기임신합병자궁기류술중처리방법.방법:회고성분석2003년1월지2008년8월재본원치료적193례만기임신합병자궁기류환자적림상자료,병안분면방식、기류대소、기류류형진행분조,대기술중출혈량、수술시간급술후주원천수진행비교.결과:부궁산술전진단임신합병자궁기류104례,술전진단솔53.9%;부궁산가자궁기류척제술술중출혈량、수술시간화술후주원천수여단순부궁산상비차이무통계학의의(P>0.05);임신합병궁체기류조수술시간교임신합병자궁하단급궁경부기류조명현축단(P=0.007);>8 cm기류조여≤2 cm기류조、2～5 cm기류조화>5～8 cm기류조상비교,수술시간명현연장,술중출혈량현저증다(P<0.05);점막하기류조적수술시간、술중출혈량화술후주원천수균교장막하기류조현저연장(P<0.05).결론:대우임신합병자궁기류환자,수진조명학진단,병근거자궁기류적류형、위치급대소화환자적년령급생육수구、유무기타엄중임신합병증등종합고필이결정분면방식화술중처리방법.대직경>8cm적기류、자궁하단급궁경부기류、점막하기류적처리응근신.
Objective:The treatment of late pregnancy complicated with utedne leiomyoma was investigated.Methods:193 Cases of Iate pregnancy complicated with uterine leiomyoma from January 2003 to August 2008 were recruited in our hospital.According to the delivery route,size and subtype of fibroid,blood loss,operation hours and postoperative inpatient period were compared.Results:104 cases of pregnancy complicated with uterine leiomyoma were diagnosed before cesarean section(CS).No significant differences on blood losses and operation hours were found between CS group and CS+myomectomy group(P>0.05).The operation heurs of leiomyoma in corpus uteri was significantly shorter than leiomyoma in lower uterine segment and cervix(P=0.007).Leiomyoma bigger than 8 cm needed significantly Ionger operative hours and lose more blood than the smaller leiomyoma.Operation hours,blood loss and postoperative inpatient period were significantly different between submucous leiomyoma and subserosal leiomyoma(P<0.05).Conclusions:Pregnancy complicated with uterine leiomyoma should be diagnosed as early as possible.During cesarean section on when leiomyoma is bigger than 8 cm,locating at lower uterine segment or cervix or submucous,the treatment should be cautious.