非瘢痕子宫破裂误诊为胎盘早剥一例并文献复习.docVIP

精品论文 参考文献 非瘢痕子宫破裂误诊为胎盘早剥一例并文献复习 王华1 张晓霏2 刘艳秋3 江苏大学附属医院 江苏镇江 212001 　　【摘 要】目的：探讨非瘢痕妊娠子宫破裂的临床特点并分析误诊原因。方法：结合相关文献对我院收治的一例非瘢痕妊娠子宫破裂的临床资料进行回顾性分析。结果：产妇于孕41 周在当地社区医院予缩宫素引产，引产过程中突发腹痛、阴道流血，疑胎盘早剥，急诊转入我院，抗休克同时积极行子宫下段剖宫产术，术中发现确诊为子宫体部纵形裂开。结论：非瘢痕子宫破裂临床罕见，易误诊为胎盘早剥。详细询问病史、仔细查体，尽早明确诊治，有助于改善预后。 　　【关键词】非瘢痕子宫；子宫破裂；胎盘早剥；误诊Spontaneous uterine rupture of an unscarred uterus misdiagnosed as placental abruption: case report and review of the literatureWang Hua1 Zhang Xiaofei 2 Liu Yanqiu3(Affiliated Hospital of Jiangsu University Zhenjiang Jiangsu 212001)【Abstract】Objective To explore clinical characteristic of spontaneous uterine rupture of an unscarred uterus and analyze themisdiagnosis causes. Methods Clinical data of a patient with spontaneous uterine rupture of an unscarred uterus in our hospital wasretrospectively analyzed, and related literature was reviewed. Results The patient was a 37-year-old women Gravida 1 para 1 at 41 weekrsquo;gestation with no past history of uterine surgery. The local hospital use oxytocin to induce labor. During oxytocin intravenous dripping, thepatient felt spontaneous pelvic pain and suffered vaginal bleeding soon. The patient was diagnosed as placental abruption and send to ourhospital. Anti-shock therapy was given and cesarean section was performed at once. During the operation, we found that the uterus body wasruptured vertically. Conclusion The diagnosis of spontaneous uterine rupture is difficult in an unscarred uterus, and may be easilymisdiagnosed as placental abruption. Clinicians should ask medical history and give physical examination carefully. The earlier diagnosis andtreatment are taken, the better the prognosis will be.【Key Words】Unscarred uterus; Spontaneous uterus rupture; Placental Abruption; Misdiagnosis【中图分类号】R714.25【文献标识码】B【文章编号】2096-0867（2015）-08-117-03 　　子宫体部或子宫下段在妊娠期或分娩期发生破裂称为子宫破裂，如未及时诊断与治疗，常引起母儿死亡，文献报道的子宫破裂发生率为0.07permil;左右[1]。子宫破裂的症状和体征主要取决于发生时间的长短、破裂位置及损伤程度；但子宫破裂最初的症状和体征并无特异性[2]。我院收治非瘢痕子宫破裂一例，病初误诊为胎盘早剥，现总结分析如下。 　　1. 病例资料女，37