急诊子宫切除术在产科大出血中的应用及评价

Application of emergency hysterectomy on severe postpartum hemorrhage

目的探讨产科急症子宫切除术在抢救产科大出血中的应用价值。方法采用回顾性分析方法,对本院2003年10月至2007年9月期间收治的6例因产科急症行子宫切除术患者的临床资料进行分析。结果6例均为经保守治疗不能控制的产科大出血患者,其中DIC2例,子宫内翻1例（1例合并DIC）,宫缩乏力1例（1例为双胎妊娠）,子宫破裂2例。出血量1600-3500ml,平均2380ml。6例患者均行子宫切除术后痊愈出院。相关因素分析显示,孕产次、多胎妊娠、分娩方式等因素与产科急症子宫切除术相关。结论产科急症子宫切除术是治疗急性产科大出血的有效措施之一。

Objective To investigate the value of emergency hysterectomy on arresting severe postpartum hemorrhage. Methods A retrospective analysis was performed on 6 cases with hysterectomy by reason of postpartum hemorrhage between October 2003 and March 2007. Results All the patients were severe postpartum hemorrhage that couldn＇ t be controlled by conservative treatment. Among them, there were 2 cases of DIC, 1 cases of uteroplacental apoplexy （one of them is and DIC） , 1 cases of uterine atony（ one of them is twin preg- nancy）, 2 cases each of uterine rupture and uterus of malformation（ being and placenta implantation）. Blood loss averaged 2380 ml. All the 6 pationts were recovered. Emergency hysterectomy was related to times of gestation and delivery and also to delivery pattern. Conclusion Emergency hysterectomy is one of the effective methods on arresting severe postpartum hemorrhage.