剖宫产时子宫肌瘤切除术:一项前瞻性多中心研究

N. Akhter, F. Begum, N. Begum, S. B. Chowdhury, N. Fatema, S. A. Amin, Z. Hasan, F. Rahman, Anwer Hossain
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引用次数: 2

摘要

背景:子宫肌瘤切除术可以在剖宫产术中进行。目的:评价剖宫产术中子宫肌瘤切除术的安全性和有效性。方法:研究设计是一项前瞻性多中心研究,在达卡医科大学、BSMMU和达卡市私立医院的三家三级医院进行。研究对象为剖宫产术中择期或急诊子宫肌瘤切除术的孕妇65例。所有剖宫产子宫肌瘤切除术均由咨询医生进行。评估术中及术后并发症,如红细胞压积变化、手术时间、出血量等。住院时间也被记录下来。结果:65例患者共切除大小肌瘤79个(2 ~ 6cm)。子宫前壁肌瘤多见于浆膜下和壁内。4例患者术后全血输注1单位。剖宫产时未行子宫切除术。红细胞压积、术后发热发生率和手术时间无明显变化。术后住院研究平均时间7.3±1.2天,5例患者相继怀孕,研究期间多次行剖宫产术。结论:在选定的病例中,剖宫产术中的子宫肌瘤切除术如果由经验丰富的医生进行,似乎不会导致产时或产后短期发病的风险增加。剖宫产子宫肌瘤切除术是一种安全的手术选择,没有明显的并发症。现代与先进医学研究2019;6(1):18-22
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Myomectomy at the time of Cesarean Section: A Prospective Multicentre Study
Background: Myomectomy can be performed during cesarean section. Objective: The purpose of the present study was to assess the safety and efficacy of myomectomy during cesarean section. Methodology: The study design was a prospective multi-centre study done in three tertiary care hospitals Dhaka Medical Collage, BSMMU & private Hospital in Dhaka City. The subject were 65 pregnant women elective or emergency myomectomy during cesarean section. All cesarean section myomectomy were performed by consultants. Intra-operative and post-operative complications such as change in haematocrit, length of operation, blood loss were estimated. Length of hospital stay was also recorded. Results: 79 Fibroid of various sizes (2 to 6cm) were removed from 65 women. Fibroid were on the anterior uterine wall with most being sub serous and intra mural. Four patients had one unit of whole blood transfusion in post-operative period. No hysterectomy was done at the time of cesarean section. There was no significant change of haematocrit: incidence of post-operative fever and duration of operation. The mean duration of post-operative hospital study was 7.3±1.2 days, 5 patients subsequently became pregnant, were also underwent repeated cesarean section in the study period. Conclusion: In selected cases myomectomy during cesarean section does not appear to result in an increased risk of intrapartum or short-term post-partum morbidity if performed by an experienced practitioner. Cesarean myomectomy is a safe surgical options with no significant complications. Journal of Current and Advance Medical Research 2019;6(1):18-22
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