孕产期无剖宫产手术史自发性子宫破裂4例临床分析  

Clinical Analysis of 4 Cases of Spontaneous Uterine Rupture without History of Cesarean Section

作　　者：韦艳 孙倩玉[1] 杨萍 WEI Yan;SUN Qian-yu;YANG Ping(Department of Gynaecology and Obstetrics,the First Hospital of Shihezi University School of Medicine,Xinjiang Shihezi,832008;People's Hospital of Shihezi,Xinjiang Shihezi,832000)

机构地区：[1]石河子大学医学院第一附属医院妇科,新疆石河子832008 [2]石河子市人民医院产科,新疆石河子832000

出　　处：《农垦医学》2020年第6期561-566,共6页Journal of Nongken Medicine

基　　金：新疆生产建设兵团科技攻关项目(2017DB012)。

摘　　要：目的:分析孕产期无剖宫产手术史自发性子宫破裂的临床特点及预防措施。方法:收集2017年1月至2019年12月就诊于新疆石河子市人民医院产科的4例孕产期无剖宫产手术史自发性子宫破裂患者的病例资料,结合文献对其临床特征进行分析。结果:孕产期无剖宫产手术史自发性子宫破裂发生率0.05%(4/7486)。4例子宫破裂患者,包括1例因右侧宫角妊娠行右侧输卵管切除术,1例有人工流产史及宫腔镜下输卵管插管通液术史,1例有两次药流不全清宫术史,1例因试产后活跃期延长子宫不完全破裂。4例患者中有2例为足月待产入院,无典型子宫破裂症状,试产失败手术中发现子宫破裂;另外2例初始表现为腹痛,结合辅助检查考虑为子宫破裂。4例患者均行剖腹探查证实子宫破裂,且破裂部位位于宫底或宫角处,术中行紧急剖宫产联合子宫破裂修补术及相应对症治疗后,患者预后良好。结论:增加对孕产期无剖宫产手术史自发性子宫破裂的认识,及早确诊,对预防及诊治孕产期子宫破裂的发生至关重要。Objective:To analyze the clinical characteristics and preventive measures of spontaneous uterine rupture without cesarean section.Methods:The clinical data of 4 patients with spontaneous uterine rupture who had no history clinical characteristics were analyzed combined with the literature.Results:The incidence of spontaneous uterine rupture was 0.05%(4/7486).Therewere 4 cases of uterine rupture,including 1 case underwent right salpingectomy due to right cornual pregnancy,1 case had history of induced abortion and hysteroscopic tubal catheterization,1 case had two times of incomplete uterine curettage,and 1 case had incomplete uterine rupture due to prolonged active period after trial delivery.Among the 4 patients,2 cases were admitted to hospital for full-term labor,without typical symptoms of uterine rupture,and uterine rupture was found during the operation;the other 2 cases initially showed abdominal pain,which was considered as uterine rupture combined with auxiliary examination.All the 4 patients underwent laparotomy to confirm the rupture of uterus,and the rupture site was located at the fundus or cornual.After emergency cesarean section combined with uterine rupture repair and corresponding symptomatic treatment,the prognosis of the patients was good.Conclusion:It is very important to increase the understanding of spontaneous uterine rupture without cesarean section history and to make early diagnosis.

关 键 词：子宫破裂 自发性 剖宫产 孕产期 

分 类 号：R714.4[医药卫生—妇产科学]