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目的探析36例分娩期子宫破裂患者的临床病因、诊治、预防手段。方法对36例分娩期子宫破裂患者的资料进行研究。结果全部孕妇中,合并阔韧带血肿6例,膀胱裂伤3例,失血性休克20例,弥漫性血管内凝血4例,急性肾功能衰竭3例。26例应用子宫修补术方案治疗,8例采用次全子宫切除术,2例行全子宫切除术。其中1例患者由于弥散性血管内凝血(DIC)合并多脏器功能衰竭而发生死亡,其他均治愈出院。围生儿死亡19例,病死率为52.78%。所有并发症中,失血性休克比例最大,占55.56%。结论通过对分娩期子宫破裂患者的临床病因、诊治、预防手段的探讨,从而有效预防孕妇出现不完全性子宫破裂,预防并发症,提高临床诊治效果。
Objective To investigate the clinical etiology, diagnosis, treatment and prevention of 36 cases of uterine rupture in childbirth. Methods The data of 36 cases of uterine rupture during childbirth were studied. Results In all pregnant women, there were 6 cases of broad ligament hematoma, 3 cases of laceration of the bladder, 20 cases of hemorrhagic shock, 4 cases of diffuse intravascular coagulation and 3 cases of acute renal failure. 26 cases were treated with uterine repair, 8 cases were treated with subtotal hysterectomy and 2 cases were treated with hysterectomy. One patient died of disseminated intravascular coagulation (DIC) complicated with multiple organ failure, and the rest were cured. Perinatal death in 19 cases, the case fatality rate was 52.78%. Hemorrhagic shock was the largest proportion of all the complications, accounting for 55.56%. Conclusions The clinical etiology, diagnosis, treatment and prevention of uterine rupture in childbirth are discussed in order to prevent incomplete uterine rupture, prevent complications and improve clinical diagnosis and treatment.