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1969～1990年,我院行产科子宫切除术54例,占同期分娩总数的0.08％。其中剖宫产切除子宫47例,阴道分娩切除子宫7例。患者年龄25～41岁,平均30.8岁。经产妇30例,初产妇24例。其中双胎5例。孕周≤24周5例,25～32周6例,33～36周3例,37～42周40例。子宫全切除8例,次全切除46例。死亡1例,系羊水栓塞;腹壁窦道1例;其余均痊愈。现作如下讨论。 1.手术指征的选择①难以控制的产后出血。本组有45例,失血量最多7800ml,最少800ml,平均2195ml。其中28例在手术时已处于休克状态,3例出现了DIC。在抢救休克的同时迅速切除子宫,有效地控制了出血。出血原因有:a.胎盘植入21例,占38.89％(21/54);b.宫缩乏力9例,占16.67％(9/54);c.前置胎盘、胎盘早剥并发子宫胎盘卒中各6
From 1969 to 1990, 54 cases underwent obstetric hysterectomy in our hospital, accounting for 0.08% of the total number of deliveries in the same period. Including 47 cases of cesarean section excision of the uterus, vaginal delivery of the uterus in 7 cases. Patients aged 25 to 41 years, an average of 30.8 years old. After the maternal 30 cases, 24 cases of primipara. Five of them were twins. Pregnancy weeks ≤ 24 weeks in 5 cases, 25 to 32 weeks in 6 cases, 33 to 36 weeks in 3 cases, 37 to 42 weeks in 40 cases. Hysterectomy in 8 cases, subtotal resection in 46 cases. 1 case of death, Department of amniotic fluid embolism; 1 case of abdominal wall sinus; the rest were cured. The following discussion. 1. Selection of surgical indications ① difficult to control the postpartum hemorrhage. The group of 45 cases, the maximum amount of blood loss 7800ml, at least 800ml, an average of 2195ml. Of these, 28 had been in shock at the time of surgery and 3 had DIC. In the rescue of shock at the same time the rapid removal of the uterus, effectively controlled the bleeding. The causes of bleeding were as follows: a. Placenta accreta in 21 cases, accounting for 38.89% (21/54); b, uterine atony in 9 cases, accounting for 16.67% (9/54); c. Placenta previa, Stroke each 6