【2017年整理】分娩期子宫破裂20例临床诊断与治疗.docVIP

PAGE PAGE 1分娩期子宫破裂20例临床诊断与治疗 席和红（蓬安县人民医院妇产科 637800 HYPERLINK mailto:paldj431@163.com paldj431@163.com）摘要: 目的 探讨子宫破裂的病因、诊断治疗及预防措施，减少孕产妇及围产儿死亡。 方法 收集2002～2008年蓬安县人民医院收治的20例分娩期子宫破裂病例，对其临床资料进行回顾性分析。 结果 不全性子宫破裂8例，完全性子宫破裂12例；导致子宫破裂的病因中，瘢痕性子宫11例，梗阻性难产3例，产前不当使用宫缩剂1例，多次生产5例；死胎8例，死产6例，新生儿存活6例，围产儿死亡率70%（14/20）；9例行子宫破裂修补术，9例行子宫次全切除术，2例行子宫全切术。 结论 加强产前检查，密切观察产程，避免忽略性难产的发生。有剖宫产史或子宫切开手术史及多次生产者，应提前住院待产，根据指征及前次手术情况决定本次分娩途径，若无梗阻性难产存在，也可在严密观察下经阴道分娩。对缩宫素、前列腺素等子宫收缩剂的使用指征、方法应严格掌握，避免滥用。严格掌握剖宫产及各种阴道手术指征。关键词:分娩期；子宫破裂；瘢痕性子宫；难产；手术治疗 Childbirth uterine rupture of 20 cases of diagnosis and treatment.作者简介：席和红 女 1976年2月14日出生 四川广安人 妇产科主治医师作者简介：席和红 女 1976年2月14日出生 四川广安人 妇产科主治医师 大学学历 擅长妇产科(Department of obstetrics and Gynecology, Pengan County peoples hospital,pengan, 637800,China)Abstract:Objective To investigate the cause of uterine rupture, diagnosis, treatment and prevention measures to reduce maternal and perinatal deaths. Methods From 2002 to 2008 in our hospital admitted 20 cases of uterine rupture during childbirth cases, the clinical data were retrospectively analyzed. Results 8 cases of incomplete uterine rupture, 12 cases of complete uterine rupture; leading causes of uterine rupture in 11 cases of uterine scar, three cases of obstructive dystocia, improper use of prenatal uterine agent in 1 case, multiple production of 5 cases ; 8 cases of fetal death, 6 cases of stillbirth, neonatal survival in 6 cases, perinatal mortality of 70% (14/20); 9 cases of uterine rupture repair, 9 routine hysterectomy operation, 2 cases of uterine Full resection. Conclusion To strengthen prenatal care, and closely observe the production process, to avoid the occurrence of neglected dystocia. There is history of cesarean section or uterine incision history and multiple producers, should be produced in advance to be hospitalized, according to indications, and previous surgeries decided to organize the delivery means, in the absence of obstructive dystocia exist, can also be under close observation