产后出血致子宫切除23例临床分析

Clinical Study of 23 Cases of Hysterectomy with Postpartum Hemorrhage

目的：探讨产后出血的病因和防治措施.方法：分析23例产后出血致子宫切除的原因及处理过程.结果：[1]产后出血的原因依次为胎盘因素、宫缩乏力、羊水栓塞、子宫破裂、剖宫产切口愈合不良;[2]从分娩方式看,经阴道分娩切除子宫2例,剖宫产分娩切除子宫21例;[3]因产后出血而导致的子宫切除在剖宫产和阴道分娩中所占的比例有显著性差异.结论：产后出血是导致孕产妇死亡的主要原因,子宫切除虽然是治疗产后出血的一项重要措施,但是严格把握剖宫产的指征,显得更为重要,降低剖宫产率,可以有效地防止因产后出血导致的子宫切除.

Objective ：To study the cause of postpartum hemorrhage and the measures of prevention and treatment. Methods The clinical data of 23 cases of hystereetomia with postpartum hemorrhage, including the etiology and treatment process, was analyzed retrospectively. Results 1. The causes of postpartum hemorrhage were in the order of placental factors, uterine inertia,amniotic fluid embolism, uterine rupture and poor healing of uterus incision;2. From the delivery mode, the hysterectomia occurred in 2 cases with vaginal delivery, 21 cases with cesarean sectlon; 3. The difference in the rate of hysterectomia caused by postpartum hemorrhage had statistical significance between the vaginal delivery and cesarean section. Conclusions The postpartum hemorrhage is the main cause of hysterectomla. The hysterectomia is an effective method for the treatment of postpartum hemorrhage. By restricting the indication of cesarean section and decreasi.ng the rate of cesarean section, the hysterectomia caused by postpartum hemorrhage can be effectively avoided.