早孕合并子宫肌瘤切除患者人工流产52例临床分析

发布时间：2018-04-17 21:48

  本文选题：子宫肌瘤切除术后 + 药物流产术　； 参考：《中国妇产科临床杂志》2017年04期

【摘要】：目的探讨早孕合并子宫肌瘤切除术史患者的终止妊娠方式及子宫肌瘤切除对人工流产术(人流)并发症的影响。方法回顾性分析52例宫内妊娠6~10周合并子宫肌瘤、子宫腺肌瘤切除史患者的临床资料,同时选取60例无子宫肌瘤切除史早孕妇女为对照组,其中超声引导下人工流产30例、药物流产(药流)30例。结果 52例患者中宫腔镜下黏膜下肌瘤切除术10例,腹腔镜下29例,开腹13例;合并子宫腺肌7例;单发子宫肌瘤或腺肌瘤34例,多发子宫肌瘤18例;术前肌瘤最大直径1.5~11 cm,直径≥5 cm 40例,5 cm 12例;肌瘤切除距离妊娠时间8个月~15年;9例胎囊距离子宫浆膜层小于1 cm,均经MRI检查排除胎囊子宫肌层种植。23例采用超声引导下负压电吸人工流产术,均为一次成功,23例B超监视下,与其人流对照组比较,手术时间明显延长(P0.05),但术中出血量及术后残留率比较,差异无统计学意义(P0.05)。29例(包括胎囊距离子宫浆膜层小于1 cm 9例)药物流产术,残留率为27.59%,明显高于其药流对照组(P0.05)。结论对于早孕合并子宫肌瘤切除术史患者,超声引导下人流术定位准确、损伤性小,明显减少了术后残留,手术安全性高;对于可能存在子宫切口愈合欠佳者,药物流产可减少严重并发症的发生。
[Abstract]:Objective to investigate the termination of pregnancy in patients with early pregnancy complicated with hysteromyomectomy and the effect of hysterectomy on complications of induced abortion.Methods the clinical data of 52 cases of intrauterine pregnancy with uterine leiomyoma and adenomyoma resection history were analyzed retrospectively. 60 cases of early pregnancy without hysterectomy were selected as control group, including 30 cases of ultrasonic guided induced abortion.Drug abortion (30 cases).Results among 52 patients, 10 cases underwent hysteroscopic submucous myoma resection, 29 cases underwent laparoscopy, 13 cases underwent laparotomy, 7 cases complicated with adenomyoma, 34 cases with single uterine myoma or adenomyoma, 18 cases with multiple uterine myoma.Before operation, the maximum diameter of myoma was 1.5 ~ 11 cm, the diameter 鈮，

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