摘要
目的分析严重产后出血时行子宫切除术的高危因素,探讨其手术时机和手术方式。方法回顾性分析昆明同仁医院产科10年间收治的221例严重产后出血的临床病例资料。结果宫缩乏力、子宫破裂及胎盘植入或粘连是产后出血及严重产后出血时子宫切除术的高危因素。剖宫产后严重产后出血的发生率明显高于阴道分娩(P<0.05),出血量也明显高于阴道分娩(P<0.01)。产后出血量超过2500mL时行子宫切除术的危险性明显增高,同时产后并发症也明显增多。结论子宫因素和胎盘因素是产后出血和严重产后出血子宫切除术主要的原因,剖宫产也是导致产后出血发生率增高的主要因素之一。产科医师在面对发生严重产后出血的患者时,应积极进行保守治疗,当出血量超过2500mL时,应考虑行子宫切除术以抢救危重产后出血患者的生命。
Objectives To analysis the risk factors of severe postpartum hemorrhage treated by hysterectomy, and study the operative chance and method of severe postpartum hemorrhage treated by hysterectomy. Methods A retrospective analysis was made in 221 cases of severe postpartum hemorrhage during ten years of 1997 to 2006 in department of obstetrics and gynecology, kunming tongren hospital. Results The risk factors of hysterectomy with severe postpartum hemorrhage were uterine inertia, uterine rupture and placental adherence. The incidence of severe postpartum hemorrhage of cesarean section was higher than the incidence of delivering by vagina （P〈 0.05）, as well as the quantity of postpartum hemorrhage （P〈0.01）. The risk of hysterectomy was higher and the complications were increased when the quantity of postpartum hemorrhage was more than 2500ml. Conclusions Uterine and placental factors have become major reasons of postpartum hemorrhage and hysterectomy with severe postpartum hemorrhage. The rising cesarean section rate adds to the rising incidence of postpartum hemorrhage. The obstetricians should choice the hysterectomy to treat the patients which the quantity of postpartum hemorrhage is more than 2 500ml in order to reduce the maternal death.
出处
《中国医药指南》
2009年第22期20-21,42,共3页
Guide of China Medicine
关键词
严重产后出血
子宫切除术
相关因素
Severe postpartum hemorrhage
Hysterectomy
Related factors
