探讨急症子宫切除术在产科大出血中的应用

目的：探讨和分析急症子宫切除术运用在产科大出血患者临床治疗中的方法和效果。方法选择2014年9月—2015年9月来该院接受子宫切除的60例患者作为研究对象，所有患者都为急症产科大出血，并满足中华血液学会提出的DIC诊断标准。结果该文患者中初产妇和经产妇分别有45例和15例，分别占患者总数量的75%和25%，差异较为明显（P<0.05）；20例患者都为接受保守治疗之后无法控制大出血，其中胎盘粘连患者有12例、DIC患者有17例、子宫破裂15例、宫缩乏力12例、剖宫产术后子宫切口感染6例。患者出血量在1500到3800 mL之间，平均为（2445±10）mL，所有患者接受子宫切除手术之后得以康复，多胎妊娠、孕产次、分娩方式和患者子宫切除存在直接的关系，患者前后差异有统计学意义（P<0.05）。20例产妇共分娩23例新生儿，其中分娩双胞胎产妇有3例，单胞胎产妇有17例。结论急症子宫切除术运用在产科大出血临床治疗中能够产生显著的效果，能够减少患者出血量，提升治疗有效性。

Application of Emergency Hysterectomy in Obstetric Hemorrhage

Objective To explore and analyze the methods and effects of emergency hysterectomy in the treatment of pa-tients with obstetric hemorrhage. Methods From September 2014 to September 2015, 60 patients with hysterectomy in our hospital were selected as study subjects. All patients were diagnosed as emergency obstetric hemorrhage, and met the DIC diagnostic criteria proposed by the Chinese society of Hematology.Results The patients in primipara and multipara were 45 cases and 15 cases, which accounted for 75% and 25% of the total number of patients, obvious difference (P<0.05); 20 pa-tients for received conservative therapy to control bleeding, including patients with placenta accreta have 12 cases, DIC pa-tients with 17 cases of uterine rupture in 15 cases, 12 cases of uterine atony, after cesarean section uterine incision infec-tion in 6 cases. The amount of bleeding in 1 500 to 3 800 mL, average(2 445±10)mL. All patients underwent uterine resec-tion after recovered, multiple pregnancy, parity, mode of delivery and in patients with uterine resection direct relationship exists, differences before and after the patients with obvious(P<0.05). A total of 20 cases of maternal birth, 23 cases of new-born infants, including 3 cases of maternal twins, 17 cases of singleton pregnancy. Conclusion Emergency hysterectomy can produce significant effect in the clinical treatment of obstetric hemorrhage, which can reduce the amount of bleeding and improve the effectiveness of treatment.