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目的探讨子宫破裂发生的原因、临床特点及防治措施。方法对福建省妇幼保健院2010年1月至2012年12月期间孕产妇发生子宫破裂的21例临床资料做回顾性分析。结果瘢痕子宫是子宫破裂的首要原因(76.2%),其次是药物引产不当(9.5%)、多产次生产(9.5%)及残角子宫妊娠(9.5%)。21例子宫破裂者均行剖腹探查术,其中18例(85.7%)行子宫修补术,2例(9.5%)行全子宫切除术,1例(4.8%)行残角子宫切除术。患者经积极抢救,未发生死亡,围产儿死亡5例,术后常规抗炎治疗后均痊愈出院。结论子宫破裂是产科严重并发症,加强围产期保健,严格掌握剖宫产指征及宫腹腔镜下子宫肌瘤挖除术和宫角切除术手术指征,规范药物引产,是预防的根本措施。
Objective To investigate the causes, clinical features and preventive measures of uterine rupture. Methods The clinical data of 21 cases of maternal uterine rupture in Fujian Maternal and Child Health Hospital from January 2010 to December 2012 were analyzed retrospectively. Results Uterine scar was the leading cause of uterine rupture (76.2%), followed by improper induction of labor (9.5%), prolific multiplication (9.5%) and residual horn uterus pregnancy (9.5%). 21 cases of uterine rupture were underwent laparotomy, of which 18 cases (85.7%) underwent hysterectomy, 2 cases (9.5%) underwent hysterectomy and 1 case (4.8%) undergone hysterectomy. Patients were actively rescued, no deaths occurred, and 5 were perinatal deaths. All patients were cured after routine anti-inflammatory treatment. Conclusion Uterine rupture is a serious complication of obstetrics, to strengthen perinatal care, strict indications of cesarean section and laparoscopic uterine fibroids and hysterectomy surgery indications, regulate drug induced labor is the basis of prevention Measures.