Kwawukume E Yao
Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana.
Afr J Reprod Health. 2002 Dec;6(3):38-43.
This study was conducted at Korle Bu Teaching Hospital and Family Health Hospital, Accra, Ghana, between April 2000 and January 2001 to compare the efficacy and safety of myomectomy done at caesarean section with the application of a tourniquet with caesarean section without myomectomy. Twenty four patients were recruited into the study. Average haemoglobin of patients both pre and post-operatively was 11.73 g/dl and 9.90 g/dl for patients who had caesarean section with myomectomy and 12.07 g/dl and 10.34 g/dl in the other group in which caesarean section without myomectomy was performed. The average duration of operation was longer in patients who had caesarean section and myomectomy (62.08 mins) than those who had caesarean section alone (50.83 mins). The drop in average haemoglobin for patients who had caesarean section and myomectomy was 1.83 while those who had caesarean section alone was 1.73. This was not significant. The fibroid nodules removed ranged from one solitary nodule to six nodules with an average diameter of 6 cm. Eighty five per cent of the fibroids were intramural and in the body of the uterus. Uterine involution was normal and there were no significant complications during the puerperium. We conclude that there is no significant difference in intra-operative and post-operative morbidity and blood loss in performing caesarean section alone and caesarean section with myomectomy when a tourniquet is applied.
本研究于2000年4月至2001年1月在加纳阿克拉的科勒布教学医院和家庭健康医院进行，旨在比较剖宫产时应用止血带行子宫肌瘤切除术与单纯剖宫产的疗效和安全性。24名患者被纳入该研究。行剖宫产加子宫肌瘤切除术患者术前和术后的平均血红蛋白分别为11.73 g/dl和9.90 g/dl，另一组单纯行剖宫产患者术前和术后的平均血红蛋白分别为12.07 g/dl和10.34 g/dl。行剖宫产加子宫肌瘤切除术患者的平均手术时间（62.08分钟）长于单纯行剖宫产患者（50.83分钟）。行剖宫产加子宫肌瘤切除术患者的平均血红蛋白下降值为1.83，单纯行剖宫产患者为1.73。差异无统计学意义。切除的肌瘤结节数量从1个孤立结节到6个结节不等，平均直径为6 cm。85%的肌瘤位于子宫肌壁间及子宫体部。子宫复旧正常，产褥期无明显并发症。我们得出结论，应用止血带时，单纯剖宫产与剖宫产加子宫肌瘤切除术在术中及术后发病率和失血量方面无显著差异。
