摘要
目的评价剖宫产术中挤压法子宫肌瘤剔除术的临床应用价值。方法2008年1月～2010年12月，剖宫产术中采用挤压法剔除子宫肌瘤128例（挤压法），传统方法剔除子宫肌瘤179例（传统法）为对照组。挤压法组用纱布称重法测量剔除肌瘤的出血量。比较2组产后出血量、产后出血率、术后1天血红蛋白下降值、产后发热及术后住院时间。结果挤压法剔除子宫肌瘤的出血量为（6．57±3．68）ml。其中≥5cm肌瘤40例出血量（6．98±4．62）ml，〈5cm肌瘤88例出血量（6．39±3．17）ml；剔除浆膜下肌瘤101例出血量（6．39±3．33）ml，肌壁间肌瘤27例出血量（7．26±4．76）ml。差异均无显著性（P〉0．05）。挤压法产后出血量（233．59±58．90）ml，对照组（256．70±158．68）ml，差异无显著性（P〉0．05）。挤压法产后出血率为0％，对照组2．8％（5／179），差异无显著性（P〉0．05）。血红蛋白下降值挤压法（6．17±2．83）g／L明显小于传统法（7．1l±4．76）g／L（t=-1．996，P=0．047）。在较大肌瘤（直径≥5om）剔除时，挤压法40例产后出血量（265．00±79．42）ml，显著低于对照组44例（341．59±215．25）ml（t=-2．122，P=0．037）。2组产后发热、术后住院时间差异均无显著性（P〉0．05）。结论剖宫产术中挤压法剔除子宫肌瘤较传统方法剔除子宫肌瘤能减少产后出血量，特别是在较大肌瘤剔除时更具有优势，是一种简单、微创、安全、可行的手术方法，值得临床广泛开展。
Objective To evaluate the clinical application of myomectomy by extrusion in cesarean section. Methods 128 cases of myomectomy by extrusion in cesarean section from January 2008 to December 2010 were treated as the study group （extrusion group）, while 179 cases of myomeetomy using the traditional method were used as the control group （traditional group）. The blood loss of myomectomy in extrusion group was calculated and the postpartum blood loss, postpartum hemorrhage rate, postpartum fever rate, hemoglobin drop and postoperative hospital stay in both groups were compared. Results The blood loss of myomectomy in the extrusion group was （6.57± 3.68） ml. The blood loss of the 40 cases with leiomyoma of more than 5 cm was （ 6. 98±4.62） ml and that of the 88 cases with leiomyoma of less than 5 cm was （6.39 ± 3.17） ml; the blood loss of the 101 cases of subserous myoma dissection was （6.39 ± 3.33 ） ml and that of the 27 cases of intramural myoma removal was （7.26 ± 4.76） ml. No significant difference was observed （ P 〉0. 05 ）. The postpartum blood loss in the extrusion group was （233.59 ± 58.90） ml, and that of the control group was （256.70 ± 158.68） ml, with no significant difference between the two groups （P 〉 0.05 ）. The hemoglobin drop of extrusion group was significantly lower than that of the control group [ （6. 17 ± 2.83） g/L vs. （7. 11±4.76） g/L, t = - 1. 996, P = 0. 047 ]. When comparing myomectomy of the larger myoma （ diameter ≥ 5 cm） , the postpartum blood loss of the study group （40 cases） was （265.00 ± 79.42） ml, which was significantly lower than that of the control group （44 cases） （341.59 ±215.25 ） ml （ t = - 2. 122, P = 0. 037 ）. There was no significant difference in postpartum fever rate and postoperative hospital stay between the two groups （P 〉0. 05）. Conclusions The myomectomy by extrusion in cesarean section can reduce postpartum blood loss, which is a simple, minimally invasive, safe and feasible surgical method, especially for myomectomy of larger myoma.
出处
《中国微创外科杂志》
CSCD
2013年第9期827-830,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
妊娠
子宫肌瘤
剖宫产
子宫肌瘤剔除
挤压法
Pregnancy
Myoma of uterus
Cesarean section
Myomectomy
Extrusion
