产科急症子宫切除术19例临床分析

目的 ]探讨 10年间产科急症子宫切除术的指征 ,旨在降低其发生率 .方法 ]采用回顾性分析方法对产科急症子宫切除术 19例临床资料进行了分析 .结果 ]19例产科急症子宫切除术指征均为子宫出血 .子宫出血的原因中胎盘因素居第 1位 ,共 8例 ,其中胎盘植入 5例 ,胎盘粘连 3例 ;产后弥漫性血管内凝血居第 2位 ,共 6例 ,其中死胎滞留 3例 ,重症肝炎、重度妊娠高血压综合征及羊水栓塞各 1例 ;产后宫缩乏力居第 3位 ,共 5例 ,其中双胎 2例 .本组产妇死亡 1例 .结论 ]胎盘植入和难以控制的子宫出血是产科急症子宫切除术的主要指征 ,要降低产科急症子宫切除术的发生率 ,应做好围产期保健工作 ,加强孕期检查 ,及时诊治弥漫性血管内凝血的诱发病

Clinical analysis of hysterectomy in obstetric emergency

BACKGROUND*!The indication of hysterectomy in obstetrics emergency was studied in order to defend and decrease the incidence of hysterectomy. *!CASE REPORT*! 19 cases of hysterectomy in obstetric emergency were retrospectively analyzed. The all indication of 19 cases of hysterectomy was endometrorrhagia in obstetric emergency. The first cause of endometrorrhagia was 8 cases of placental complication in which 5 cases were placenta implantation and 3 cases were adherent placenta; the second cause was 6 cases of puerperal disseminated intravascular coagulation in which 3 cases were the retention of dead fetus and 1 cases were severe hepatitis, severe pregnancy induced hypertension and amniotic embolism, respectively; the third cause was 5 cases of puerperal uterine atony in which 2 cases were twin and 1 case of parturient was dead. *!DISCUSSION*!In order to decrease the incidence of hysterectomy in obstetric emergency, the family planning and health work of perinatal period should be done goodly, the antenatal examination should be strengthened and disseminated intravascular coagulation should be made a diagnosis and treatment timely.