15例因产科大出血急症子宫切除术的病因探讨

目的探讨产科大出血行子宫切除术的相关因素及病理改变。方法以我院2002年1月至2007年12月的6年内15例急症子宫切除术患者的临床资料作为研究对象，进行回顾性分析，探求其手术相关因素及子宫病理。结果15例急症子宫切除者中，14例行次全子宫切除术，1例行全子宫切除术。孕产妇死亡2例，抢救成功率86．67％。子宫病理有改变的10例（66．67％），其中9例子宫平滑肌出血、变性、坏死，1例有黏膜下子宫肌瘤。本资料还显示子宫切除与孕产次关系密切，P值为0．034；多胎妊娠与产后出血有密切关系（P=0．000）。结论产科大出血行子宫切除术的原因是多方面的，子宫平滑肌的病理改变可能是其重要因素之一。

Etiology analysis in 15 eases performed for hysterectomy resulted from the massive postpartum hemorrhage

Objective To discuss factors and pathology variety related to hysterectomy resulted from the massive postpartum hemorrhage.Methods By the retrospective analysis for the clinical data involved in 15 patients, who entered my hospital to perform emergency hysterectomy due to the massive postpartum hemorrhage from Jan 2000 to Dec 2007, we explored factors related to operation and uterus pathology.Results Of 15 patients performed for emergency hysterectomy, non-entire uterus was removed in 14 patients, and entire uterus in 1 patient. A total of 2 pregnant lying-in women were dead and the survival rate after operation occupied 86.67 percent. There were 10 patients with pathology variety in uterus. Among them, 9 patients showed the bleeding in uterine smooth muscle, denaturalization, putrescence and 1 submucous myoma. Moreover, the data of 15 patients also showed the occurrence of hysterectomy was closely related to the times of pregnancy and delivery (P=0.034), and mutifetal pregnancy was closely related to postpartum hemorrhage (P=0.000).Conclusion Pathology variety of uterine smooth muscle is one of vital factors resulting in the performance of hysterectomy derived from the massive postpartum hemorrhage.