18例产科急症子宫切除原因分析

The Reason Analysis of 18 Caese Hysterectomy in Emergency of Obstetrical

目的:对产科子宫切除原因进行探讨,总结经验教训。方法:通过对本院2 0 0 2年1月- 2 0 0 4年8月产科急症子宫次全切除术18例进行回顾性分析。结果:在18例子宫切除中,剖宫产时子宫切除10例,占5 5 .5 6 % ;阴道分娩时子宫收缩乏力行子宫切除4例,占2 2 .2 2 % ;子宫破裂导致子宫切除3例,占16 .6 6 % ;剖宫产后感染引起晚期产后出血切除子宫1例,占5 .5 6 %。结论:剖宫产行子宫切除的主要原因是前置胎盘、胎盘植入、胎盘早剥致子宫卒中及疤痕子宫造成的肌壁缺损而无法修补;阴道分娩时子宫收缩乏力多数是经产妇、多胎、妊娠合并贫血;子宫破裂多数是疤痕子宫以及多胎。急症产科子宫切除是治疗产时并发症、挽救产妇生命而采取的紧急措施之一,是一种破坏性手术,具有一定的特殊性,因此有必要对其发生原因及预防措施进行临床分析。

Objective:To investigate the reason of hysterectomy in obstetrical and to sum up experience.Methods:Retrospective study of 18 patients with hysterectomy in emergency of obstetrical during January 2002 to Augustg 2004.Results:In 18 patients suffered from hysterectomy,10 cares was due to caesarean section(55.56 %);4 cares was due to shrinks weary after the vainer parturition (22.22 %);3 cares was due to rupture of uterus(16.66 %);1 care was due to the late postparum hemorrhage caused by infection after caesarean section(5.56 %);Conclusion:The reason of hysterectomy after caesarean section was related to placenta prevail,Abruption placenta,Ateroplacental apoplexy and intramural injury of scar uterus;Shrinks weary after the vagina parturition majority was related to the multipart,Multiple pregnancy and gestational anemia;Rupture of uterus was related to intramural injury of scar uterus and multiple pregnancy.Hysterectomy in emergency of obstetrics is to save confined women,is an abrupt operation,Have it special.So it is necessary to analyze the cause and to take measure to prevention smoething happening.