产科出血子宫切除术21例临床分析

A clinical analysis of 21 cases of hysterectomy due to obstetric hemorrhage

目的探讨降低产科子宫切除术及术后并发症发生的可能性。方法对沙井人民医院产科近6年间因产科出血行子宫切除的病例作回顾性分析。结果30411例住院患者中共有21例因产后出血行子宫切除术，发生率为0．07％。手术指征主要为胎盘因素及子宫收缩乏力所致的失血性休克,其分别为42．86％（9／21）和28．57％（6／21）。行子宫切除术者分娩方式经比较，剖宫产者明显高于阴道分娩者（X2=11．92，P〈0．05）。结论做好计划生育和孕产妇监测，科学接生，正确掌握剖宫产的手术指征，可有效降低产科子宫切除发生率和围生儿死亡率，降低医药成本。

Objective To explore measures to lower rate of perinatal hysterectomy and incidence of postoperative complications. Methods The clinical data of patients who underwent hysterectomy due to obstetric hemorrhage and admitted to Department of Obstetrics, Shajing People＇ s Hospital of Bao＇ an District in last 6 years were retrospectively analyzed. Results Among 30 411 in-patients, 21 women received hysterectomy due to obstetric hemorrhage with a incidence rate of 0.07%. The indications of hysterectomy included hemorrhagic shock caused by uterine atony, placenta acereta, and they accounted for 42.86% （9/21） and 28.57% （6/21）, respectively. Among women who received hysterectomy,the rate of cesarean section was significantly higher than that of vaginal delivery （X2 = 11.92, P 〈 0. 05 ）. Conclusion Caning out family planning and maternal monitoring, scientific midwifery, correctly mastering surgical indications of cesarean section are effective ways to reduce the incidence of obstetric hysterectomy, perinatal mortality rate and cost of medicine.