子宫破裂20例临床分析

目的：探讨妊娠子宫破裂的原因及预防方法。方法：对1998年8月－2000年3月，也门南方阿特戈医院收治的20例子宫破裂的临床资料进行回顾性分析。结果：18例为完全性子宫破裂，2例为不完全性子宫破裂。3例合并膀胱损伤，1例同时合并膀胱及输尿管损伤，1例单纯合并输尿管损伤。4例感染严重，无继续生育要求行子宫次全切除术，16例行修补术。2例产妇死亡，病死率10％，围产儿19例死亡，病死率95％。结论：严密观察产程、严禁滥用缩宫素和前列腺素、严格掌握阴道助产指征，是预防子宫破裂的关键；术中应仔细检查有否合并泌尿道损伤，及时发现，及时修补，减少术后并发症。

Clinical analysis of 20 cases of uterine rupture

Objective:To explore pathogeny,prophylaxis and treatment of uterine rupture.Methods:Twenty cases of uterine rupture in Alaq Hospital of Yemen from August 1998 to March 2000 were analysed retrospectively.Results:Eighteen cases were diagnosed as complete uterine rupture and 2 cases as incomplete uterine rupture.Three cases were combined with vesical rupture,one case with both vesical and ureteral injury,and one case with ureteral injury.Hysterectomies were performed on 4 cases.The repairs of the uterine rupture were performed on 16 cases.Two cases died(10%).Meanwhile 19 neonates died(95%).Conclusions:This study demonstrates that the key to prevent uterine rupture is to observe the stage of labor,to forbid the abuse of oxytocin or prostaglandin and to know the indication of forceps delivery.During operation,ureteral tract injury should be repaired promptly to prevent surgical complications.