产科因素致子宫切除14例临床分析

Clinical analysis of hysterectomy by obstetric factors in 14 cases

目的分析产科因素所致子宫切除术的发生率、手术指征、手术方式、分娩方式、原发病因、诱因及预防。方法对妇产科2008年11月—2013年11月产科因素所致子宫切除的14例临床资料进行回顾性分析。结果子宫切除率0.17%(14/8213)。胎盘因素50%(7/14),为子宫切除的主要原因,高于子宫破裂等其它产科因素所致的子宫切除率;剖宫产子宫切除率0.33%(12/3678),高于阴道分娩子宫切除率0.04%(2/4535)。结论胎盘因素为子宫切除主要因素,子宫切除术是抢救孕产妇重度出血和拯救孕产妇生命的一项重大措施。孕产前预防保健,产时正确处理,防治产科并发症,降低剖宫产率,可减少子宫切除的发生,提高产科质量。

Objective To explore the incidence of hysterectomy by obstetric factors, operation indications, operation mode, the mode of delivery, the primary cause, incentive and prevention this disease. Methods From Nov. 2008 to Nov. 2013,14 cases of hysterectomy by obstetric factors in our department were analyzed retrospectively. Results The rate of hysterectomy was 0.17% （14/8213） ,with the placental factors of 50% （7/14） ,which was major factor,it was higher than factor of the uterine rupture;the rate of Hysterectomy by caesarean section was 0.33% （ 12/3678）, which was higher the factor of vaginal delivery（0.04% ,2/4535 ）. Conclusion Obstetric factor was the major cause of hysterectomy,hysterec- tomy was the major measure of rescue of maternal severe hemorrhage and save the maternal hfe. Prenatal prevention and health care, the correct treatment during intrapartum, prevention and treatment of obstetric complications and decrease the rate of caesarean section, can improve the quality of Obstetrics.