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目的:探讨晚期妊娠合并子宫肌瘤的临床特点。方法:回顾性分析2010年6月至2015年12月河源市龙川妇幼保健院收治的199例晚期妊娠合并子宫肌瘤孕妇的临床资料,统计子宫肌瘤诊断情况、妊娠期并发症、子宫肌瘤特性、分娩方式等。按剖宫产术中是否剔除肌瘤分为未剔除组(单纯剖宫产术)和剔除组(剖宫产并肌瘤剔除术);按肌瘤最大径分为≥5 cm组和<5 cm组,比较两组手术时间、术中出血量、首次肛门排气时间、住院时间等。结果:术前诊断137例(68.8%)、剖宫产术中诊断62例(31.2%);经阴道分娩32例,产程顺利。未剔除组(63例)和剔除组(103例患者)均顺利完成剖宫产术,两组手术时间比较,差异有统计学意义(P<0.05)。103例剔除组患者肌瘤最大径为0.5~10.0 cm,剔除的最大子宫肌瘤为l0 cm×10 cm×8 cm。≥5 cm组(27例)术中出血量较<5 cm组(76例)增多(P<0.05)。结论:对于妊娠合并子宫肌瘤患者,需尽早明确诊断,选择合适的分娩方式和治疗方法;当子宫肌瘤体积较大时,应酌情采取合理方式,选择剖宫产同时行肌瘤剔除安全可行。
Objective: To investigate the clinical features of uterine fibroids in late pregnancy. Methods: A retrospective analysis of clinical data of 199 pregnant women with uterine fibroids complicated with uterine fibroids admitted to Longchuan Maternal and Child Health Hospital of Heyuan City from June 2010 to December 2015 was made. The diagnosis of uterine fibroids, pregnancy complications, uterine muscle Tumor characteristics, mode of delivery and so on. According to whether the fibroids were removed in cesarean section were divided into non-rejection group (simple cesarean section) and rejection group (cesarean section and myomectomy); cm group. The operation time, intraoperative blood loss, first anal exhaust time, hospitalization time and so on were compared between the two groups. Results: 137 cases (68.8%) were diagnosed preoperatively, 62 cases (31.2%) were diagnosed by cesarean section, and 32 cases were delivered vaginally. Caesarean section was successfully completed in both non-cull group (63 cases) and cull group (103 cases). The difference was statistically significant (P <0.05). The maximal diameter of fibroids in 103 excision patients was 0.5-10.0 cm, and the largest fibroids removed were l0 cm × 10 cm × 8 cm. The blood loss in ≥5 cm group (n = 27) was significantly higher than that in <5 cm group (n = 76) (P <0.05). Conclusion: For pregnant patients with uterine fibroids, the need for a clear diagnosis as soon as possible, select the appropriate mode of delivery and treatment; when the uterine fibroids larger, should take appropriate measures, as appropriate, choose cesarean section while myomectomy safe and feasible .