102例剖宫产术中行子宫肌瘤剔除术患者血红蛋白水平情况研究-现代医学

102例剖宫产术中行子宫肌瘤剔除术患者血红蛋白水平情况研究

单位：云南省中医药大学第二附属医院妇产科, 云南昆明 650041

分类号：R711.74

出版年·卷·期（页码）：2019·47·第二期（191-194）

摘要：

目的：探究剖宫产术中行子宫肌瘤剔除术患者血红蛋白水平情况。方法：回顾分析我院2015年1月至2018年1月收治的102例行剖宫产术中予行子宫肌瘤剔除术的患者资料，与同期100例单纯用剖宫产手术患者的临床疗效及其疾病预后进行对比分析。对两组患者平均手术时间、术中出血量、术后48 h出血量、血红蛋白差值、平均住院时间及产后情况、并发症情况等进行比较分析。结果：观察组平均手术时间明显高于对照组（P<0.05）外，其他各项测量指标术中出血量、术后48 h出血量、血红蛋白差值、48 h阴道出血量及缩宫素用量差异均无统计学意义（P>0.05）。术后康复指标肛门排气、切口愈合、恶露干净及住院时间和血红蛋白下降值中，两组差异均无显著差异（P>0.05）。对照组并发症总发生率为6.00%，观察组为7.84%，组间比较，差异不显著（P>0.05）。子宫肌瘤直径<5 cm和5 cm ≤肌瘤直径≤ 8 cm的患者在术后48 h阴道出血量及手术时间均无显著差异（P>0.05），而肌瘤直径<5 cm的患者血红蛋白下降值、术中出血量则显著低于5 cm ≤肌瘤直径≤ 8 cm的患者（P<0.05）。结论：剖宫产同时行子宫肌瘤剔除术不会增加并发症，安全有效。肌瘤大小对出血量是有一定的影响，较大子宫肌瘤患者，手术难度增大，需慎重考虑。

Objective:To explore the hemoglobin level of patients undergoing hysteromyomectomy during cesarean section.Methods:the data of 102 cases of uterine myomectomy during caesarean section from January 2015 to January 2018 were reviewed and analyzed. The clinical efficacy and prognosis of 100 cases with simple cesarean section were compared and analyzed. The average operation time, the amount of bleeding in the operation, the amount of bleeding after 48 h, the difference of hemoglobin, the average time of hospitalization, the condition of postpartum and the complication of the two groups were compared and analyzed.Results:the average operation time of the observation group was significantly higher than that of the control group(P<0.05), and there was no significant difference in the amount of bleeding, 48 h hemorrhage after operation, the difference of hemoglobin, the amount of 48 h vaginal bleeding and the dosage of uterine contraction(P>0.05). There was no significant difference between the two groups(P>0.05). The total incidence of complications in the control group was 6%, while that in the observation group was 7.84%. There was no significant difference between the two groups(P>0.05). There was no significant difference in postoperative 48 h vaginal bleeding and operation time(P>0.05) in patients with uterine myoma diameter<5 cm, 5 cm~8 cm and diameter ≤ 8 cm. The decrease of hemoglobin and intraoperative haemorrhage were significantly lower than those with larger uterine leiomyoma.(P<0.05).Conclusion:Cesarean section with hysteromyomectomy does not increase complications and is safe and effective. The size of leiomyoma has a certain influence on the amount of bleeding. In patients with larger uterine leiomyoma, the difficulty of operation is increased, which should be carefully considered.

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