产科急症子宫切除术及其相关因素分析

目的:对产科急症子宫切除术及其相关因素进行分析,探讨降低产科子宫切除率,提高产科质量的方法。方法:对我院1995年6月~2005年6月产科行急症子宫切除术的31例病例进行回顾性分析。结果:产科急症子宫切除术占分娩总人数的0.095%,其中阴道分娩6例,剖宫产25例。行子宫次全切除术28例,子宫全切除术3例。手术指征为:胎盘因素16例,占51.61%(前置胎盘并胎盘粘连6例,胎盘植入7例,胎盘早剥3例),子宫破裂6例,占19.35%,宫缩乏力5例,占16.13%,宫腔感染、羊水栓塞、D IC及宫颈残端出血各1例,占3.23%。相关因素分析显示:多孕多产及分娩方式等与产科急症子宫切除术相关。结论:建立健全3级妇幼保健网,加强孕产妇保健和计划生育工作,正确掌握剖宫产指征,加强产科医师业务培训和急救技术,可以有效降低产科子宫切除率。

A study on related factors of obstetric emergency hysterectomy

Objective:Study on related factors of obstetric emergency hysterectomy,to reduce the rate of emergency hysterectomy and improve the quality of perinatal care.Methods:A retrospective study of 31 cases of emergency hysterectomy during 1995-2005 were analyzed.Results:The rate of emergency hysterectomy was 0.095%,6 cases were delivered vaginal,and 25cases were delivered by cesarean section.Total hysterectomy was performed in 3cases,subtotal in 28cases.The indications of obstetric emergency hysterectomy were placenta factors,uterine rupture,uterine agony etc.Emergency hysterectomy was related to times of gestation and delivery and also to delivery pattern.Conclusion:To improve the parental care,and to advocate family planning,and to master the indication of cesarean section,and to train the obstetrical doctors appropriately can efficiently reduce the incidence of obstetrical emergency hysterectomy.