开腹子宫肌瘤切除术后的宫腔粘连：一项审计。
Intrauterine adhesions after open myomectomy: an audit.
作者信息
Conforti Alessandro, Krishnamurthy Geeta B, Dragamestianos Christos, Kouvelas Sotirios, Micallef Fava Alison, Tsimpanakos Ioannis, Magos Adam
机构信息
University Department of Obstetrics and Gynecology, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK.
University Department of Obstetrics and Gynecology, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK.
出版信息
Eur J Obstet Gynecol Reprod Biol. 2014 Aug;179:42-5. doi: 10.1016/j.ejogrb.2014.04.034. Epub 2014 May 24.
OBJECTIVE
To estimate the incidence of intrauterine adhesions after open myomectomy.
STUDY DESIGN
A prospective audit descriptive study was conducted involving thirty-six women who had undergone open myomectomy for symptomatic fibroids at a large undergraduate teaching hospital. A follow-up out-patient hysteroscopy was performed three months after surgery.
RESULTS
At hysteroscopy, eighteen patients (50%) were found to have mild to moderate intrauterine adhesions. The number of fibroids removed was significantly higher in patient who developed adhesions (median value 22 versus 9.5, p<0.05). Pre-operative GnRHa therapy, uterine size, opening of the uterine cavity during surgery, specimen weight, estimated blood loss, post-operative bleeding or pyrexia were similar whether or not adhesions were found.
CONCLUSION
Open myomectomy represents an important but currently underappreciated aetiological factor in the formation of intrauterine adhesions.
目的
评估开腹子宫肌瘤剔除术后宫腔粘连的发生率。
研究设计
一项前瞻性审计描述性研究纳入了三十六名在一家大型本科教学医院因有症状的子宫肌瘤接受开腹子宫肌瘤剔除术的女性。术后三个月进行门诊宫腔镜随访。
结果
宫腔镜检查时，发现18例患者（50%）有轻度至中度宫腔粘连。发生粘连的患者切除的肌瘤数量明显更多（中位数分别为22个和9.5个，p<0.05）。无论是否发现粘连，术前GnRHa治疗、子宫大小、手术中子宫腔开放情况、标本重量、估计失血量、术后出血或发热情况均相似。
结论
开腹子宫肌瘤剔除术是宫腔粘连形成的一个重要但目前未得到充分认识的病因。
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