产科手术急救中行子宫切除的临床研究

Clinical study of emergency obstetric hysterectomy operation

目的探讨产科剖宫产术中行子宫切除术的原因、必要性以及手术操作的注意事项。方法回顾分析2008年1月—2013年12月于该院行剖宫产手术,术中行子宫切除术的20例患者。结果本文20例患者于剖宫产术中行子宫切除术,占总分娩人数的0.028%。其中10例因胎盘因素行子宫切除,占50%;5例因宫缩乏力、难治性弥散性血管内凝血行子宫切除,占25%;3例因羊水栓塞行子宫切除,占15%;因子宫破裂、子宫畸形行子宫切除的患者各1例,分别占子宫切除总数的5%。结论剖宫产术中根据病因采取对应的止血方式后,如仍无法控制出血、病情危急时应果断行子宫切除术以挽救患者生命。

Objective To investigate the causes, obstetric cesarean hysterectomy surgery is necessary, and operation precautions in operation. Methods From 2008 January to 2013 December in our hospital of caesarean operation, 20 cases of hysterectomy pa- tients. Results In the 20 patients with cesarean hysterectomy snrgery, total labor number 0.028%. Among 10 cases of hysterectomy due to placental factors, accounting for 50%; 5 cases of uterine atony, refractory disseminated intravascular coagulation hysterecto- my, accounted for 25%; 3 cases of amniotic fluid embolism underwent hysterectomy, accounted for 15%, due to rupture of the uterus, uterine malformation underwent hysterectomy patients in all 1 cases, accounted for the uterus excision of 5% of the total. Conclusion Cesarean section according to the cause and take corresponding after hemostasis, if still unable to control bleeding, in critical condition should be decisive for hysterectomy in order to save the lives of patients.