Clinical analysis of 18 cases of emergency hysterectomy
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摘要: 目的:探讨产科急症子宫切除的相关因素、手术时机及应注意的问题。方法:对2006～2012年18例产科急症子宫切除术患者的临床资料进行回顾性分析。结果:18例急症子宫切除中因胎盘因素14例(77. 8%)、子宫破裂3例(16. 7%)、羊水栓塞1例(5. 6%);其中11例处于失血性休克状态,而且难以控制的子宫大出血仍持续存在。结论:多次刮宫、多次孕产、剖宫产是产科子宫切除的高危因素,急症子宫切除是挽救孕产妇生命的重要措施,加强围生期保健,降低剖宫产率,可以有效降低产科急症子宫切除率。Abstract: Objective: To investigate the factors related to the emergency hysterectomy，operation duration and the questions concerned. Methods: The clinical data of 18 cases having received hysterectomy in obstetric emergency from 2006 to 2012 were analyzedretrospectively. Results: Among the 18 cases，14 were due to placental factors( 77. 8%) ，3 uterine rupture( 6. 7%) and 1 amniotic fluid embolism( 5. 6%) . Eleven of the 18 patients were in a hemorrhagic shock state and had persisted refractory uterine bleeding. Conclusions: Multiple curettage，multiple pregnancy and cesarean section are the high risk factors for maternal hysterectomy;emergency hysterectomy might save the life of the patients. Forceful perinatal health care and low rate of cesarean section can effectivelyreduce the rate of emergency obstetric hysterectomy.
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Keywords:
- hysterectomy /
- postpartum hemorrhage /
- placental factors
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