30例产科急诊子宫切除术的分析  

Clinical analysis on 30 cases of emergency obstetric hysterectomy

作　　者：任细姝 江玉华[1] 陈凤华[1] 袁兰凤 邱敏玲[1] 

机构地区：[1]广州市花都区妇幼保健院产科,510800

出　　处：《国际医药卫生导报》2014年第19期2938-2942,共5页International Medicine and Health Guidance News

基　　金：广州市花都区医疗卫生科研项目（14-HDWS-057）

摘　　要：目的分析比较2010年、2011年、2012年、2013年四年间在我院行产科急诊子宫切除术病例，探讨如何掌握产科急诊子宫切除术的指征及怎样降低产科急诊子宫切除率。方法回顾性分析我院四年间30例行产科急诊子宫切除术的病例。结果①2013年的剖宫产率明显高于2010年、2011年、2012年，但是2013年产科急诊子宫切除率并没有增加；②胎盘因素（70％）是产科急诊子宫切除术的主要指征；③2013年中阴道塞纱术及Bakri球囊填塞术明显高于前三年，差异有统计学意义（χ^2=1001．36、39．65，P=0．000、0．000）；④2013年中产后出血发生率、产科急诊子宫切除率明显低于前三年，差异有统计学意义（χ^2=16．56、3．26，P=0．000、0．039）。结论①要预防胎盘异常的发生，来降低产科急诊子宫切除率；②Bakri球囊填塞术可提高产后出血抢救成功率，同时降低转诊率；③阴道塞纱术可降低产后出血率；④降低产后出血率及Bakri球囊填塞术均可降低产科急诊子宫切除率。Objective To compare and analyze the emergency obstetric hysterectomy in the four years from January 2010 to December 2013, so as to master the surgical indications and reduce the incidence of obstetrical emergency hysterectomy. Method We retrospectively analyzed 30 patients admitted in our hospital from January 2010 to December 2013. Results Firstly, the rate of caesarean section in 2013 was obviously higher than those in 2010-2012, but the incidence of the emergency obstetric hysterectomy in 2013 didn＇ t go up; secondly, the main indications of emergency obstetric hysterectomy were placental factors （70%）; thirdly, both the using of plugging the yarn in vagina and the usage rate of Bakri balloon in 2013 were significantly higher than those in the three years from January 2010 to December 2012, （χ^2=1001.36, 39.65, P=0.000, 0.000）; fourthly, the incidence of the emergency obstetric hysterectomy and the rate of postpartum hemorrhage in 2013 were both obviously lower those in the three years from January 2010 to December 2012 （χ^2=16-56, 3.26, P=0.000, 0.039）. Conclusion Firstly, we should prevent the occurrence of abnormal placenta in order to reduce the incidence of obstetrical emergency hysterectomy; secondly, the use of Bakri balloon could advance the success rate of the rescue of postpartum bleeding, and reduce the referral rate; thirdly, the using of plugging the yarn in vagina could reduce the rate of postpartum hemorrhage; fourthly, the lower rate of the postpartum hemorrhage and the usage of Bakri balloon both could reduce the incidence of obstetrical emergency hysterectomy.

关 键 词：产科急诊子宫切除术 Bakri球囊 降低 

分 类 号：R713.42[医药卫生—妇产科学]