妇科手术后妊娠子宫破裂4例临床分析及文献复习  

Uterine rupture in pregnancy after gynaecologic surgery: clinical analysis of 4 cases and literature review

作　　者：曹京红[1] 于飞 翟建军[1] CAO Jing-hong;YU Fei;ZHAI Jian-jun(Department of Obstetrics and Gynecology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,P.R.China)

机构地区：[1]首都医科大学附属北京同仁医院妇产科,北京100730

出　　处：《中国计划生育和妇产科》2020年第4期84-88,I0003,共6页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨妇科手术后瘢痕子宫患者发生妊娠子宫破裂的特点,与手术之间的关系,以减少妇科手术后妊娠子宫破裂风险。方法回顾性分析2011年6月至2016年8月首都医科大学附属北京同仁医院妇产科收治的4例有妇科手术史的妊娠子宫破裂患者的病例资料,了解其临床表现、妊娠结局及相关手术情况。结果4例妊娠子宫破裂患者中2例曾行腹腔镜子宫肌瘤剔除术,1例曾行腹腔镜异位妊娠手术,1例有人工流产术后持续腹痛病史。4例患者来院时均呈休克状态,均已胎死宫内。结论任何造成子宫瘢痕的手术均可能发生妊娠子宫破裂的远期并发症,应将此类患者作为妊娠子宫破裂的高危人群加以重视。Objective To investigate the characteristics of uterine rupture( UR) during pregnancy in patients with scar uterus following a history of gynaecologic surgery,and its relationship with gynaecologic surgery,so as to reduce the risk of UR. Methods Retrospectively reviewed the medical data of 4 patients who developed UR in pregnancy following a history of gynaecologic surgery admitted in Beijing Tongren Hospital, Capital Medical University from June 2011 to August 2016. To understand clinical manifestations,pregnancy outcomes and relevant gynaecologic surgeries of these 4 cases. Results Among 4 patients with UR,2 had undergone laparoscopic myomectomy,1 had undergone laparoscopy of ectopic pregnancy,1 had a history of persistent abdominal pain after induced abortion. These 4 patients were all in shock and with fetal die in uterus when admitted to hospital. Conclusion Any surgery which results in uterus scar may cause long-term complications of UR in pregnancy. We need to regard these patients as group with high risk of UR.

关 键 词：妇科手术 瘢痕子宫 妊娠子宫破裂 

分 类 号：R714.46[医药卫生—妇产科学]