完全性子宫破裂11例临床分析  

Clinical analysis of 11 cases of complete uterine rupture

作　　者：刘盈盈[1] 孙森森 王佩 何茂旭 裴越 付莉[2] LIU Yingying;SUN Sensen;WANG Pei;HE Maoxu;PEI Yue;FU Li(Graduate School of Jilin University,Changchun Jilin 130000;Department of Obstetrics and Gynecology,the Second Hospital of Jilin University,Changchun Jilin 130021,P.R.China)

机构地区：[1]吉林大学研究生院,吉林长春130000 [2]吉林大学第二医院妇产科,吉林长春130021

出　　处：《中国计划生育和妇产科》2020年第10期87-90,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨完全性子宫破裂的危险因素、临床表现及治疗措施。方法回顾性分析2014年1月至2019年7月吉林大学第二医院收治的11例完全性子宫破裂的临床资料。结果11例患者平均孕周为27^(+3)周,其中2例宫角妊娠:例7左侧宫角部破裂伴胎盘植入,例9左侧宫角部破裂(孕囊游离于腹腔);其余9例中原剖宫产瘢痕处破裂4例,后壁近左侧宫角处破裂1例,右侧子宫下段破裂1例,后壁及宫底破裂1例,右侧壁近峡部及部分直肠全层破裂1例,宫角处破裂1例。其中10例患者均康复出院,1例死亡。胎儿结局:除外5例引产患者及2例宫角妊娠患者,胎死宫内1例,无生机儿1例,胎儿轻度窒息2例。结论瘢痕子宫是子宫破裂的主要危险因素,但其它危险因素也应引起重视。应对子宫破裂,应尽量减少无指征剖宫产,做好产前保健,严密观察产程进展,规范缩宫剂应用,尽早明确诊断,及时手术治疗。Objective To investigate the risk factors,clinical manifestations and treatment of complete uterine rupture.Methods The clinical data of 11 cases of complete uterine rupture admitted to the Second Hospital of Jilin University from January 2014 to July 2019 were retrospectively analyzed.Results The average gestational weeks of 11 patients were 27+3 weeks,including 2 cases of cornual pregnancy:example 7 was of left cornual rupture with placenta implantation,example 9 was of left cornual rupture(pregnancy sac free from abdominal cavity);of the remaining 9 cases,4 cases were cesarean scar rupture,1 case was posterior wall near the left cornual rupture,1 case was right lower uterine segment rupture,1 case was posterior wall and fundus rupture in,1 case was right wall near isthmus and partial rectal full-thickness rupture and 1 case was rupture at the cornu uteri.Among them,10 patients recovered and discharged,1 died.Fetal and infant outcomes:except 5 cases of induced labor and 2 cases of cornual pregnancy,1 case was of fetal death,1 case was of lifeless infant,2 cases were of mild fetal asphyxia.Conclusion Scarred uterus is the main risk factor for uterine rupture,but other risk factors should also be paid attention to.In response to uterine rupture,unindicated cesarean section should be minimized,prenatal care should be done well,the progress of labor should be closely observed,the application of uterine contractors should be standardized,the diagnosis should be confirmed as soon as possible,and surgical treatment should be timely.

关 键 词：完全性子宫破裂 瘢痕妊娠 母儿预后 

分 类 号：R713.4[医药卫生—妇产科学]