完全子宫破裂误诊分析  

Study on Misdiagnosis of Complete Uterine Rupture

作　　者：郝丽英[1] HAO Li-ying(Department of Perinatal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing,100026, China)

机构地区：[1]首都医科大学附属北京妇产医院围产医学部,北京100026

出　　处：《临床误诊误治》2018年第12期21-23,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨完全子宫破裂的临床特点、误诊原因及防范措施。方法对我院收治的10例误诊为其他疾病的完全子宫破裂的临床资料进行回顾性分析。结果本组9例以腹痛为首发症状,1例以分娩期胎心异常为首发症状,初诊均误诊,误诊为先兆流产或先兆早产4例,误诊为胃肠炎2例,误诊为阑尾炎、胆囊炎、胰腺炎及胎儿窘迫各1例。术前确诊为完全子宫破裂2例,术中确诊8例。10例均行子宫修补术,术后患者均存活,且无远期并发症发生,死胎、死产、新生儿重度窒息发生率为50%(5/10)。结论重视完全子宫破裂的高危因素,提高临床诊断思维能力,全面采集病史,有助于减少误诊误治。Objective To investigate the clinical characteristics,causes of misdiagnosis and preventive measures of complete uterine rupture.Methods The clinical data of10patients with complete uterine rupture who were misdiagnosed in Beijing Obstetrics and Gynecology Hospital,Capital Medical University,from January2011to December2017were studied retrospectively.Results Nine of the10patients presented to our hospital with abdominal pain as the initial symptom,and the other one presented with abnormal fetal heart rate during labor as initial symptom.Of them,4cases were initially misdiagnosed as threatened abortion or threatened preterm labor,1as gastroenteritis,1as appendicitis,1as cholecystitis,1as pancreatitis and1as fetal distress.Two of the10patients were diagnosed as complete uterine rupture before the operation,while the other8were later diagnosed during the operation.All patients received uterine repair and survived the operation without long-term complications.The incidence of intrauterine fetal death,stillbirth and severe asphyxia in neonates was50%(5/10).Conclusion It is helpful to reduce the misdiagnosis and mistreatment to attach importance to risk factors for complete uterine rupture,enhance the doctor's ability of clinical thinking and collect the medical history carefully and thoroughly.

关 键 词：子宫破裂 误诊 流产 先兆 胃肠炎 

分 类 号：R711.4[医药卫生—妇产科学]