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中国临床研究:2020,33(9):1177-1180
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产科急症子宫切除60例分析
(山西医科大学第一医院产科,山西 太原 030000)
Obstetric emergency hysterectomy:analysis of 60 cases
(Department of Obstetrics, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030000, China)
摘要
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投稿时间:2020-03-18   网络发布日期:2020-09-20
中文摘要: 目的 分析比较次全子宫切除及全子宫切除在产科的应用。方法 回顾性分析2008年1月至2019年9月收治的60例产科急症子宫切除患者的临床特点,根据手术方式的不同将其分为次全子宫切除组(27例)和全子宫切除组(33例)。采用t检验、秩和检验、χ2检验等方法对数据进行统计学分析。结果 (1)2008-2019年因产科因素行急症子宫切除的患者共60例,子宫切除率为0.22%(60/27 627)。(2)因胎盘植入行全子宫切除的患者比例高于次全子宫切除组(26/33与11/27,χ2=9.094,P=0.003),其他因素引起的子宫切除两组间差异无统计学意义。(3)全子宫切除组术中出血量高于次全子宫切除组 [(4.1±2.8)L vs(2.9±2.0)L,t=2.260,P=0.024]。(4)全子宫切除组泌尿外科参与治疗的比例高于次全子宫切除组(14/33 vs 4/27,χ2=5.390,P=0.020)。(5)仅1例患者术后出现不明原因发热、腹泻,转上级医院,余患者均痊愈出院。围生儿死亡率为7.02%(4/57)。结论 近年产科全子宫切除率呈上升趋势,与凶险性前置胎盘合并胎盘植入的发生率升高有关。
中文关键词: 子宫切除术  手术方式  胎盘植入  产科
Abstract:Objective To analyze and compare the application of subtotal hysterectomy and total hysterectomy in obstetrics. Methods The clinical characteristics of 60 cases of obstetric emergency hysterectomy in First Hospital of Shanxi Medical University from January 2008 to September 2019 were retrospectively analyzed.According to the different surgical methods, they were divided into subtotal hysterectomy group (27 cases) and total hysterectomy group (33 cases). Results From 2008 to 2019, 60 patients underwent emergency hysterectomy due to obstetric factors.The hysterectomy rate was 0.22% (60/27 627).The proportion of patients with total hysterectomy due to placenta accreta was higher than that of subtotal hysterectomy group (26/33 vs 11/27, χ2 = 9.094, P=0.003).There was no significant difference in hysterectomy caused by other factors between the two groups.Intraoperative blood loss in total hysterectomy group was higher than that in subtotal hysterectomy group[(4.1±2.8)L vs (2.9±2.0)L, t=2.260, P=0.024].The proportion of urinary surgery in total hysterectomy group was higher than that in subtotal hysterectomy group (14/33 vs 4/27, χ2=5.390, P=0.020).Only one patient developed fever and diarrhea of unknown cause after operation, and transferred to the superior hospital.The rest patients were cured and discharged.The perinatal mortality rate was 7.02%(4/57). Conclusion In recent years, the rate of total hysterectomy in obstetrics is on the rise, which may be related to the increased incidence of pernicious placenta previa complicated with placenta accreta.
文章编号:     中图分类号:    文献标志码:A
基金项目:山西省软科学研究基金(2017041041-4)
引用文本:
赵春林,杨海澜,杨艳红.产科急症子宫切除60例分析[J].中国临床研究,2020,33(9):1177-1180.

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