胎盘早剥孕妇围产期行子宫切除的临床分析

Clinical Analysis on Peripartum Hysterectomy Due to Placental Abruption

目的探讨胎盘早剥孕妇大出血时需行急诊子宫切除的临床高危因素、手术时机以及母婴结局。方法回顾性分析我院产科2007年~2012年的资料,6年间确诊胎盘早剥(PA)167例,行急症子宫切除4例。结果我院胎盘早剥发生率0.56%(167/29900),2.40%(4/167)的孕妇因胎盘早剥大出血而切除子宫;其临床高危因素有妊娠期高血压疾病及高龄;子宫切除组的平均出血量、出血大于2000 m L的比率、输血量、输血率均显著大于子宫未切除组(P<0.05)。结论重视有高危因素的胎盘早剥产妇,准确把握切除子宫的时机。

Objective To investigate the clinical high risk factors, the timing of operation, and the outcome of maternal and fetal care for emergency hysterectomy in pregnant women with placental abruption.Methods A retrospective analysis of our hospital from 2007 to 2012, 6 years of diagnosis of placental abruption （PA） in 167 cases, 4 cases underwent emergency hysterectomy.Results In our hospital, the incidence of placental abruption in 0.56% （167/29900）, 2.40% （4/167） of the pregnant women because of placental abruption and bleeding and hysterectomy; the clinical risk factors of disease and senile hypertension of pregnancy; the average amount of bleeding hysterectomy group, bleeding rate, more than 2000 mL of blood transfusion, blood transfusion rate were signi？ cantly higher than that of the uterus without resection group （P〈0.05）.Conclusion Pay attention to the risk factors of placental abruption mothers, accurately grasp the hysterectomy time.