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目的探讨剖宫产同时剔除子宫肌瘤的可行性及必要性,减少因子宫肌瘤行二次手术带来的创伤、心理负担及经济损失。方法回顾本院2009～2011年剖宫产同时发现子宫肌瘤,剔除与未剔除肌瘤病例术中出血量对比,术后远期随访观察。剖宫产同时剔除肌瘤者21人,未剔除者12人,将这2组在术中出血量,术前及术后3d血色素、产后半年之内是否因肌瘤需二次手术作为对照。结果剔除肌瘤者与剔除肌瘤术中出血量无明显差异;远期观察剔除肌瘤者21例中,术后半年之内无一例因肌瘤需行二次手术;相反未剔除者12例中,一例因产褥期一直血性恶露不止行子宫次全切除,一例术后因肌瘤导致月经量过多,中度贫血,假孕疗法半年行肌瘤剔除术,月经恢复正常。结论剖宫产同时剔除肌瘤很有必要,出血不多,可以忽略不计;术后无一例因子宫肌瘤需二次手术。
Objective To investigate the feasibility and necessity of removing uterine fibroids from cesarean section and reduce the trauma, psychological burden and economic loss caused by secondary surgery of uterine fibroids. Methods The hospital from 2009 to 2011 cesarean section at the same time find the uterine fibroids, excluding cases of non-fibromyalgia bleeding volume comparison, postoperative long-term follow-up observation. Cesarean at the same time excluding fibroids 21 people, not excluding 12 people, these two groups in the amount of bleeding, preoperative and postoperative 3d hemoglobin, postpartum within six months because of fibroids required secondary surgery as a control. Results There was no significant difference in the amount of hemorrhage between the patients with fibroids and those with fibroids removed. Among the 21 cases with long-term observation of fibroids, none of them had undergone secondary surgery within half a year after operation. In contrast, 12 , One case of bloody lochia has been due to not only subtotal hysterectomy, a case of postoperative fibroids caused by excessive menstrual flow, moderate anemia, pseudomyxomyoma half line myomectomy, menstruation returned to normal. Conclusion Cesarean section at the same time removing fibroids is necessary, bleeding is small, can be ignored; no case of uterine fibroids due to secondary surgery.