开腹和腹腔镜下子宫肌瘤切除术后患者妊娠结局临床分析

发布时间：2018-07-25 16:06

【摘要】：目的探讨不同手术方式子宫肌瘤切除术对妊娠结局的影响。方法回顾性分析2009年1月至2014年10月北京大学人民医院妇产科收治的有开腹或腹腔镜下子宫肌瘤切除史101例孕妇的临床资料。根据手术方式将其分为腹腔镜组(50例)和开腹组(51例)。比较两组孕妇子宫肌瘤切除术中肌瘤的位置、大小、数目、术后感染、妊娠距手术时间及妊娠后母儿结局。结果腹腔镜组和开腹组孕妇的年龄、手术中肌瘤大小、类型、部位和个数比较,差异均无统计学意义(P0.05)。腹腔镜组手术后妊娠时间[(2.7±1.2)年]与开腹组[(4.3±2.5)年]比较,差异有统计学意义(P0.05)。两组孕妇的分娩孕周、阴道分娩、产后出血量、早产、新生儿体质量2 500g比例比较,差异均无统计学意义(P0.05)。两组孕妇均无前置胎盘、胎盘早剥及胎盘植入发生。腹腔镜组发生1例子宫破裂。结论开腹或腹腔镜下子宫肌瘤切除术对有生育要求的子宫肌瘤患者均安全可行,可获得较满意的母儿结局。
[Abstract]:Objective to investigate the effect of different surgical procedures on pregnancy outcome. Methods the clinical data of 101 pregnant women with history of laparotomy or laparoscopic hysterectomy were retrospectively analyzed from January 2009 to October 2014 in the Department of Gynecology and Obstetrics of the people's Hospital of Peking University. The patients were divided into laparoscopic group (50 cases) and open group (51 cases). The location, size, number, postoperative infection, gestational time and maternal and fetal outcome of myoma were compared between the two groups. Results there was no significant difference in age, size, type, location and number of myoma between laparoscopy group and laparotomy group (P0.05). The gestational time after operation in the laparoscopic group [(2.7 卤1.2) years] was significantly different from that in the open group [(4.3 卤2.5) years] (P0.05). There was no significant difference in the proportion of gestational weeks, vaginal delivery, postpartum bleeding, premature delivery and newborn weight of 2 500 g between the two groups (P0.05). There was no placenta previa, placental abruption and placenta accreta in both groups. One case of uterine rupture occurred in the laparoscopic group. Conclusion Laparoscopic or open hysterectomy is safe and feasible for patients with uterine leiomyoma with fertility requirement, and satisfactory maternal and fetal outcomes can be obtained.
【作者单位】：北京大学人民医院妇产科;北京市丰台区铁营医院妇产科;
【分类号】：R737.33

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