目的探讨妊娠合并子宫肌瘤行剖宫产术中切除的疗效。方法本组研究对象共96例，均为同时间段收集且行剖宫产治疗，根据是否患有子宫肌瘤定为肌瘤组与对照组各48例，观察子宫肌瘤情况、位置及大小等，对比两组患者手术时间、术中出血时间、术后恶露干净时间、住院时间及并发症情况。结果肌瘤组术前及术中证实，肌瘤组单发27（56．25％）例，多发21（43．75％）例。术后病理证实均为平滑肌瘤。术中发现≥5cm肌瘤患者37例，＜5cm肌瘤11例；其中浆膜下14例，肌壁间16例，黏膜下2例，浆膜下合并肌壁间肌瘤16例。术后观察肌瘤组手术时间明显大于对照组（t＝13．72，P＜0．05）；手术时间、术中出血量、恶露干净时间及并发症对比差异均无统计学意义（均P＞0．05）。肌瘤组1例产后出血量增加（壁间肌瘤＞8cm），2例感染，3例切口液化；对照组2例并发症患者均为切口液化。结论妊娠合并子宫肌瘤行剖宫产中同时切除肌瘤是可行的。术前、术中、术后合理止血，均可有效提高手术成功率。%Objective To explore the curative effect of pregnancy complicated with uterine myoma undergoing myomectomy during cesarean section .Methods The study recruited 96 cases selected in the same period and undergoing cesarean section .They were divided into uterine myoma group and control group with 48 cases in each according to whether patients developed uterine myoma .The position and size of uterine myoma were observed .Two groups were compared in operation time , intraoperative bleeding time , lochia-stopping time after operation, hospitalization stay and complications .Results Preoperative and intraoperative results confirmed that there were 27 cases with single myoma(56.25%) and 21 cases with multiple myoma (56.25%).Postoperative pathological results confirmed leiomyoma .There were 37 cases with uterine myoma ≥5cm and 11 cases with uterine myoma <5cm.Of all cases, 14 were subserous myoma , 16 were intramural myoma , 2 were submucosal myoma , and 16 were subserous and intramural myoma .The operation time of uterine myoma group was obviously longer than that of control group (t=13.72,P<0.05).The differences in operation time, intraoperative bleeding, lochia-stopping time and complications between two groups were not significant ( all P>0.05 ) .Operation time in fibroids group was obviously longer than that of the control group (t=13.72, P<0.05).The differences in operation time , amount of bleeding, lochia clean contrast time and complications were not statistically significant (all P>0.05).Postpartum bleeding increase occurred in one case (intramural myoma>8cm), infection developed in 2 cases and incision infection was found in 3 cases in myoma group.There were 2 cases with incision infection in the control group .Conclusion It is feasible to perform myomectomy during cesarean section for pregnancy complicated with uterine myoma .Preoperative , intraoperative and postoperative hemostasis in proper ways can effectively improve the success rate of operation .
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