胎盘早剥致子宫卒中的治疗与监护

目的 探讨胎盘早剥合并子宫卒中的治疗原则与监护措施.方法 回顾性分析本院五年来诊治的胎盘早剥并发子宫卒中28例,结合临床讨论治疗原则与相关措施.结果 28例胎盘早剥并发子宫卒中均及时终止妊娠并行剖宫产术取出胎儿与胎盘后,经过及时恰当的处理,22例保留子宫,4例发生难于控制的大出血而行子宫次全切除术,2例子宫卒中面积大,经积极处理无效而行子宫切除.结论 胎盘早剥合并子宫卒中,严重危及母婴生命,应及时终止妊娠,但子宫卒中不是子宫切除的手术指征,只要处理及时恰当,多能保留子宫,降低母婴的死亡率.

Treatment and Monitoring of Uterine Apoplexy Induced by Placental Abruption

Objective To explore the principle of treatment and monitoring of uterine apoplexy induced by placental abruption.Methods 28 cases of uterine apoplexy with placental abruption in my hospital in the recent 5 years were analyzed retrospectively. Explored the treatment principle and the corresponding measures relating clinic.Results Among 28 cases of placental abruption with uterine apoplexy which had cesarean section to make the pregnancy to the end timely and took the fetus and placental out, after handling timely and properly, 22 cases retained the uterus, 4 cases had subtotal hysterectomy because of hematorrhea difficult to control, 2 cases had total hysterectomy because of big area of uterine apoplexy and being ineffectually handled.Conclusion Placental abruption with uterine apoplexy are badly dangerous to the lives of mother and infant. The pregnancy should be made to the end timely. But uterine apoplexy is not the indication of subtotal hysterectomy. Most uterus can be retained and the incidences of the death of mother and infant can be decreased if being handled timely and properly.