产科急症子宫切除术48例临床分析
Chinese Journal of Clinical Obstetrics and Gynecology(2013)
Abstract
目的探讨降低产科急症子宫切除术发生率的措施。方法青岛市第八人民医院产科20年间分娩总数50526例,回顾分析其中48例急症子宫切除术病例的临床资料。结果行产科急症子宫切除术的病例占分娩总数的0.095%(48/50526),其中阴道分娩11例,剖宫产37例。手术指征为:胎盘因素27例,占56.25%;宫缩乏力14例,占29.17%;子宫破裂4例,占8.33%;凝血功能障碍3例,占6.25%。其中经产妇子宫切除中胎盘因素最为多见(69.70%,23/33),而初产妇中宫缩乏力占主要因素(60.00%,9/15)。有74.09%(20/27)的胎盘异常患者有前次剖宫产或子宫手术史。结论胎盘因素是导致产科急症子宫切除术的主要危险因素。积极预防胎盘异常种植的发生,可以有效地降低产科子宫切除率。
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Key words
postpartum hemorrhage,previous cesarean section,abnormally invasive placentation,emergency obstetric hysterectomy
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