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目的探讨紧急子宫切除术在难治性产后出血中的应用及产后出血的高危因素及其防治措施。方法回顾性分析2010~2014年北京市朝阳区妇儿医院12例因难治性产后出血行紧急子宫切除术患者的临床经过及其围产结局。结果12例患者均因失血性休克、弥散性血管内凝血(disseminated intravascular coagulation,DIC),保守性手术效果不佳,行紧急子宫切除术,其中11例为全子宫切除,1例为次全子宫切除;2例出现心跳骤停,均抢救成功,其中1例遗留神经系统后遗症。结论选择恰当的时机施行紧急子宫切除术,不仅可挽救患者生命,也减少或避免了严重并发症的发生。
Objective To investigate the application of emergency hysterectomy in refractory postpartum hemorrhage and the risk factors of postpartum hemorrhage and its prevention and treatment. Methods The clinical and perinatal outcomes of 12 patients undergoing emergency hysterectomy for refractory postpartum hemorrhage from 2010 to 2014 in Beijing Chaoyang District Women and Children Hospital were analyzed retrospectively. Results All 12 patients underwent emergency hysterectomy due to hemorrhagic shock, disseminated intravascular coagulation (DIC) and conservative surgery. Among them, 11 cases were hysterectomy and 1 case was subtotal uterus Excision; cardiac arrest occurred in 2 cases, were successfully rescued, of which 1 cases left the nervous system sequelae. Conclusion Choosing the right time to perform emergency hysterectomy not only saves the life of patients but also reduces or avoids the serious complications.