产科出血致子宫切除的病理与产科因素分析  

Hysterectomy resulted from postpartum hemorrhage:an analysis of pathological and obstetrical factors

作　　者：杜红雁 韩香 张瑜 徐长福 DU Hong-yan HAN Xiang ZHANG Yu XU Chang-fu(Department of Pathology, Maternity and Children Hospital of Shanxi Province, 1616 Yan Xiang Road, Xi＇an 710061, China)

机构地区：[1]陕西省西安市西北妇女儿童医院病理科,西安710061 [2]陕西省西安市西北妇女儿童医院妇产科,西安710061

出　　处：《诊断病理学杂志》2016年第11期841-844,849,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨产科子宫出血的病理及临床特点。方法采用回顾性资料分析方法,对我院1990-01—2015-06间52例因产科出血行子宫次全或全切术患者的产科及子宫-胎盘病理资料进行整理分析。结果 52例经保守治疗无法控制的产科大出血患者中,与子宫-胎盘病理因素(胎盘粘连、胎盘植入和超常胎盘部位反应)相关的37例;与产科因素(宫缩乏力、前置胎盘、胎盘早剥和羊水栓塞等)相关的15例;与病理及产科因素协同相关的11例。结论对产科子宫出血应当从子宫-胎盘病理与临床产科因素两个方面寻找原因,子宫-胎盘病理因素比较隐匿,通过术后病理检查才能发现。Objective To investigate the pathological and clinical characteristics of severe postpartum hemorrhage. Methods A retrospective analysis was performed in 52 cases of hysterectomy owing to postpartum hemorrhage. Results All the patients were postpartum hemorrhage of obstetrical disorders that could not be controlled by conservative treatment. Among them, there were 37 cases of placental adherence, implantation and abnormal reaction of placental site, 15 cases of uterine inertia, placenta previa, amniotic fluid embolism and so on, and 11 cases induced by both pathological and obstetrical causes. Conclusion For postpartum hemorrhage we ought to find both its obstetrical and pathological factors. Especially we should not overlook the latter.

关 键 词：子宫切除 产科出血 胎盘植入 胎盘粘连 超常胎盘部位反应 

分 类 号：R737.33[医药卫生—肿瘤]