摘要
19例急症产科子宫切除术中,18例指征为子宫出血,其中15例为剖宫产,3例阴道产,说明剖宫产是急症子宫切除的高危因素。但阴道产子宫切除失血量多于剖宫产者,且易引起死亡。子宫出血的首位原因是各种胎盘异常,其发生与多次流产有关;1例指征为羊水栓塞症,因手术过晚,产妇死亡。指出在失血代偿期经连续、迅速、系统的治疗后,子宫出血仍得不到控制者,应立即果断地切除子宫。
Among 19 cases of emergency cesarean hysterectomy the indications of 18 cases was uterine hemorrhage, 15 cases were cesarean section (CS) and 3 eases were vaginal delivery (VD). It has been shown that CS is the high risk factor of emergency obstetrical hysterecto- my. Blood loss of VD was more than CS and leaded easier to maternal death. The first rea- son of uterine bleeding was some kind of abnormal placenta related to frequent abortion. The indication of one case was amnion fluid embolism who died because operation was per- formed too late. It was pointed that if bleeding still couldn' t be coltrolled through counti- nous, fast and systematical treatment including primary, formal and special therapies in the compensatory period hysterectomy should be done immediately and decisively.
关键词
剖宫产
子宫出血
子宫切除术
hysterectomy
cesarean section
uterine bleeding maternal death
