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目的分析产时、产后子宫切除的发生率、手术指征、并发症及经验教训,探讨产前、产时、产后出血的预防措施。方法采用回顾性资料分析方法,对本院1997年5月至2007年5月因产科出血切除子宫的15例临床资料整理分析。结果10年中本院分娩总数11556例,15例行子宫切除术,发生率约为1.3‰。胎盘因素10例,其中胎盘植入8例,前置胎盘2例;产后宫缩乏力3例;羊水栓塞1例;子宫破裂1例。结论产时产后出血、胎盘因素为子宫切除主要因素,子宫切除为产科出血救治的措施和手段。
Objective To analyze the incidence of postpartum hysterectomy, operative indications, complications and experiences and lessons, and to explore the preventive measures of prenatal, intrapartum and postpartum hemorrhage. Methods The retrospective data analysis method was used to analyze the clinical data of 15 cases of uterus due to obstetric hemorrhage from May 1997 to May 2007 in our hospital. Results The total number of deliveries in this hospital was 11 556 cases in 10 years and 15 cases were performed hysterectomy, the incidence was about 1.3 ‰. 10 cases of placental factors, including placenta accreta in 8 cases, placenta previa in 2 cases; postpartum uterine inertia in 3 cases; amniotic fluid embolism in 1 case; 1 case of uterine rupture. Conclusion The postpartum hemorrhage during delivery and the placental factors are the main factors of hysterectomy. The hysterectomy is the measure and means of obstetric hemorrhage.