摘要
目的通过研究妊娠合并子宫肌瘤患者孕前、孕期及产后1年肌瘤的最大直径,揭示孕期肌瘤大小的变化特点,并探讨剖宫产同时行子宫体部子宫肌瘤剔除的可行性。方法采用回顾性分析的方法,收集2017年1月至2020年1月在厦门大学附属第一医院治疗的160例妊娠合并子宫肌瘤患者的临床资料,以孕前、孕13^(+6)周前、孕14~27^(+6)周、孕28~36^(+6)周、37周至分娩及产后1年这6个时间点,观察子宫肌瘤最大直径的变化情况;探讨剖宫产同时剔除宫体部肌瘤是否安全可行。结果孕13^(+6)周前比孕前肌瘤明显增大(P<0.001);37周至分娩比孕28~36^(+6)周的肌瘤明显减小(P<0.05);产后1年比37周至分娩的肌瘤明显缩小(P<0.001);剖宫产剔除子宫体部肌瘤组较未剔除组患者的年龄、住院天数、住院费用及出血量差异均无统计学意义(P>0.05)。对比不同数目、不同大小的子宫体部肌瘤患者术中出血量差异无统计学意义(P>0.05)。结论孕期子宫肌瘤较孕前及产后1年显著增大,且孕13^(+6)周前增大迅速明显,孕28~36^(+6)周是峰值,37周至分娩有所缩小,产后1年明显缩小;剖宫产同时行子宫体部子宫肌瘤剔除是可行的,但不是必需的。
Objective To investigate the development trend of uterine leiomyoma during pregnancy through the study of the maximum diameter of the myoma in the pre-pregnancy,pregnancy and 1 year after childbirth,and to study the feasibility of uterine corpus myomectomy in the pregnant women during caesarean section.Methods Retrospective analysis and follow-up were used,and the clinical data of 160 cases of pregnancy complicated with uterine leiomyoma receiving treatment from January 2017 to January 2020 in First Affiliated Hospital of Xiamen University were collected.The development trend of the maximum diameter of uterine leiomyoma was observed at the six time points:pre pregnancy,at 1-13^(+6) weeks of gestation,14-27^(+6) weeks of gestation,28-36^(+6) weeks of gestation,37 weeks delivery and 1 year after childbirth.The feasibility of performing uterine corpus myomectomy during cesarean section was studied.Results The myoma was significantly bigger in 1-13^(+6) weeks of gestation compared to that before pregnancy(P<0.001).The myoma significantly decreased in 37 weeks-delivery than in 28-36^(+6) weeks of gestation(P<0.05).Compared with 37 weeks-delivery,the myoma at 1 year after childbirth significantly reduced(P<0.001).There was no significant difference in the age,hospitalization expenses,the days of hospital stay or amount of haemorrhage between the group receiving myomectomy and the group without myomectomy(P>0.05).According to the number and size of uterine corpus leiomyomas,there was no significant difference in amount of haemorrhage(P>0.05).Conclusion Compared to pre-pregnancy and 1 year after childbirth,uterine myoma during pregnancy increases significantly;there is a remarkable increase in 1-13^(+6) weeks of gestation and reaches the peak at 28-36^(+6) weeks of gestation;the myoma decreases significantly in 37 weeks-delivery;the myoma decreases significantly at 1 year after childbirth;It is feasible to remove uterine corpus myomas during cesarean section,but it is not necessary.
作者
任璐璐
颜晓红
洪艺煌
林锦蓉
王艳清
陈琼华
REN Lu-lu;YAN Xiao-hong;HONG Yi-huang;LIN Jin-rong;WANG Yan-qing;CHEN Qiong-hua(First Affiliated Hospital of Xiamen University,Xiamen 361004,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2021年第7期778-781,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家自然科学基金面上项目(81871145)
国家重点研发计划(SQ2017YFSF080005)
厦门市妇科疾病研究与诊疗重点实验室建设基金。
关键词
妊娠
子宫肌瘤
剖宫产
子宫体部肌瘤剔除术
pregnancy
uterine leiomyoma
esarean section
uterine corpus myomectomy
