妊娠合并子宮肌瘤142例病例分析

柳亞芬+張鳳格

【摘要】目的：探究與分析妊娠合并子宮肌瘤的臨床特點。方法：選取我院自2014年11月至2015年7月收治的142例妊娠合并子宮肌瘤孕產婦作為觀察組，另選擇同時期收治的140例妊娠無合并子宮肌瘤的孕產婦作為對照組，對比兩組孕產婦孕期合并癥、分娩期并發癥發生率、分娩方式、術中處理及子宮肌瘤在妊娠期的變化。結果：觀察組與對照組先兆流產、先兆早產、胎位異常、前置胎盤、妊高征、胎膜早破、胎兒生長受限、妊娠糖尿病發生率相比均無明顯差異（P>0.05）。觀察組與對照組臍帶纏繞、胎兒窘迫、產后出血、胎盤早剝、新生兒窒息、低出生體重兒發生率相比均無明顯差異（P>0.05）。觀察組較對照組相比陰道分娩率降低，剖宮產率提高，具有統計學意義（P<0.05）。觀察組術中同時行子宮肌瘤剔除術73例，占51.41%。孕晚期肌瘤直徑較早期相比無增大或減小所占比例最高，占49.30%，明顯高于其他情況，具有統計學意義（P<0.05）。剔除肌瘤后病理類型表現為肌瘤未伴變性比例最高，占47.95%，明顯高于其他類型，具有統計學意義（P<0.05）。結論：妊娠合并子宮肌瘤不會增加孕產婦孕期及分娩期并發癥發生率，同時不會增加肌瘤變性比例，且子宮肌瘤大小并非隨著孕期延長而增大，但增加了剖宮產率，因此也應引起臨床醫師的重視。

【關鍵詞】妊娠；子宮肌瘤；合并癥

Pregnancy with uterine fibroids： analysis of 142 casesLIU Yafen， ZHANG Fengge. Department of Obstetrics and Gynecology，ShunYi District Maternal and Children Health Care Hospital， Beijing 101300， China

【Abstract】Objectives： To explore and analyze the clinical features of pregnancy with uterine fibroids. Methods： 142 pregnant patients with hysteromyoma in our hospital from November 2014 to July 2015 were selected as observation group， and another 140 pregnant women without uterine fibroids at the same time were chosen as control group. The incidence of pregnant complications and intrapartum complications， delivery mode， changes in secondary processing and uterine fibroids during pregnancy were compared. Results： The incidence in threatened abortion， aura， abnormal position， placenta previa， premature pregnancy， and high character， premature rupture of membranes， fetal growth restriction and gestational diabetes mellitus had no obvious difference between the two groups （P> 0.05）. Difference in the incidence of umbilical cord entanglement， fetal distress and postpartum hemorrhage， placental abruption， neonatal asphyxia and low birth weight was not significant （P> 0.05）. Compared with the control group， the vaginal birth rate was lower and the cesarean section rate was higher in the observation group， with statistical significance （P<0.05）. In the observation group， there were 73 cases underwent myomectomy， accounting for 51.41%. Compared to earlier， late pregnancy fibroids diameter kept stable in most patients， accounting for 49.30%， significantly higher than the other conditions， with statistical significance （P<0.05）. After eliminating fibroid， the pathological type of non-degenerated fibroids was of the highest percentage， accounting for 47.95%， significantly higher than other types， with statistical significance （P<0.05）. Conclusion： Pregnancy with uterine fibroids doesnt increase the incidence of maternal pregnancy and intrapartum complication rates， and at the same time will not increase the proportion of myoma degeneration， but will increase the rate of cesarean section， and the size of uterine fibroids does not as increases prolong pregnancy， which should cause the attention of clinicians.endprint

【Key words】Pregnancy； Uterine fibroids； Complications

【中圖分類號】R711.74【文獻標志碼】A

子宮肌瘤作為臨床上一類發病率較高的婦產科良性腫瘤，以多發性子宮肌瘤最為常見，對產婦妊娠分娩過程及新生兒健康均可造成諸多影響。據調查研究資料顯示，子宮肌瘤好發于卵巢功能較為旺盛的25～45歲之間的婦女，且隨著絕經期的到來，部分女性由于年齡的增長，卵巢功能的減退，子宮肌瘤大多可自行縮小[1]。大量臨床研究資料顯示，絕大多數子宮肌瘤患者并無明顯的臨床癥狀，僅有少數患者合并出現嚴重腹部疼痛、陰道出血及壓迫周圍器官等癥狀[2]。但是，妊娠合并子宮肌瘤的出現，可能對產婦身心健康造成諸多影響，需引起臨床醫師的重視[3]。現我院針……