产后出血性子宫切除临床研究

Clinical research of postpartum hemorrhage hysterectomy

目的分析产后出血致子宫切除患者的临床资料，探讨子宫切除的最佳手术时机。方法回顾性分析2002年1月至2011年12月10年间31例产科急症子宫切除患者的病历资料。结果31例产后大出血子宫切除患者中，胎盘因素居子宫切除首位原因（51．61％），子宫收缩乏力导致子宫切除居第2位（29．03％）。出血量在1000～6000ml，平均4130ml。31例患者均输血，输血量800—3800ml，平均2280ml。结论子宫切除是治疗产后严重出血、抢救孕产妇生命的重要措施；掌握子宫切除最佳手术时机，对于减少后术并发症，降低孕产妇病死率具有重要意义。

Objective To analyze the clinical data of patients with postpartum hemorrhage hysterectomy, and to explore the eptimal timing of surgery for hysterectomy. Methods Retrospectively analyzed the clinical data of 31 hysterectomy patients in ten years which from January 2002 to December 2011. Results In the 31 patients, placental factor was the leading cause of hysterectomy（51.61% ）, and the second factor was uterine contraction atony（25.9% ）. Blood loss was about 1000 -6000 ml,the mean blood loss was 4130 ml. All 31 patients were given blood transfusion, the blood transfusion was 800 -3800 ml, the average blood transfusion was 2280 ml. Conclusions Hysterectomy is an important measure to treat severe postpartum bleeding and to rescue maternal life; master the operation chance has a vital significance to decrease postoperative complication and reduce maternal mortality.