严重产后出血子宫切除术相关因素的分析.pdfVIP

20 中闺医药指南 2009 年 11 月第 7 卷第 22 期 Guide ofChina Medicine ,November 2009 , Vo l.7,NO.22 严重产后出血子宫切除术相关因素的分析 关云泼I 张学勤z 【摘要1 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。方法回剧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边是产后出血及严重产后出血时子宫切除术的 高危因素。 4如l 宫产后严重产后出血的发生卒明显高于阴道分纯 (P 0.05) ，出血量也明显高于阴道分忧 (P 0.01)。产后出Jø..量超过 250仇nL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，剖宫户也是导f生产后出血发生牟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怠者时，应积极进行保守治 疗，当出血受超过2500mL时，应考虑行子宫切除术以抢收成吏产后出血忠者的生命. 【关键词]严萤产后出血;子宫切除术;相关因素 中朋分类号: 714.461 文献标识码: B 文章编号: 1671-8194 (2∞9) 22皿0020叩03 Analysis on Related Factors of Severe Postpartum Hemorrhage Treated by Hysterectomy 1 1 WU Yun-Bo , ZHANG Xue-Qin ρ Deparlment ofObstetrics and Gynec%gy, Kunming Tongren Hospital. Kunming 650228, China; 2 Department ofObstetrics and Gynecology, the Second Hospita/ ofKunming Medical college, Kunming 650101, China) (Abstract) Objec创ves To analysis the risk fa伽rs of 阳ere pos刷阳m hemorrhage treated by hysterectomy,and sωdy the opera创ve chance and method of sever白 postp创tum hemoηhage treated by hysterectomy. Metbods A re衍。spective analysis was made in 221 c邸es of severe postpartum hemorrhage during ten years of 1997 to 2006 in dep缸tment of obstetrics and gynecology, kunming tongren hospital. Results The risk factors of hysterectomy with severe postpartum hemorrhage w衍e uterine înertîa, uterine rupture and placental adherence. The incidence of severe postpar阳m hemorrhage of cesarean sectîon was hîgher than the incidence of delivering by vagina (P0.05), as well as the quantity of postpartum hemorrhage (PO,OI), The risk of hysterectomy was higher and the complications were increased when the q