子宫破裂23例原因和诊治分析.docVIP

子宫破裂23例原因和诊治分析 　　doi：10.3969/j.issn.1007-614x.2014.14.30 　　摘 要 目的：探讨子宫破裂的原因、诊断及治疗。方法：2007年1月-2013年12月收治子宫破裂患者23例，分析其引起的原因，归纳并总结诊断方法及治疗方案。结果：23例子宫破裂患者均及时作出诊断及急诊行剖腹探查手术治疗，患者无一例死亡。16例晚期妊娠患者中12例婴儿存活，4例婴儿死亡。15例行子宫修补术，3例行子宫全切除术，5例行子宫次全切除术。结论：瘢痕子宫破裂占78%，应慎重处理瘢痕子宫足月分娩及瘢痕子宫中期妊娠引产，慎用缩宫素及米索前列醇类制剂引产。子宫破裂大多症状典型，结合病史、体征及超声检查，诊断明确，应急诊行剖腹探查术，根据情况行子宫修补术、子宫全切除术及子宫次全切除术。 　　关键词 子宫破裂 剖腹探查术 瘢痕子宫 　　Analysis of the reason and treatment of 23 cases of uterine rupture 　　Guo Yake 　　Obstetrics and Gynecology Department of Linying County Peoples Hospital of Henan Province，462600 　　Abstract Objective：To explore the reason，diagnosis and treatment of uterine rupture.Methods：We selected 23 cases of uterine rupture from January 2007 to December 2013.We analyzed the reasons which can result in uterine rupture，and summed up the methods of diagnosis and treatment plan.Results：23 cases of uterine rupture were timely diagnosed，and were given Exploratory laparotomy operation treatment in the emergency.None of the patients died.In 16 cases of late pregnancy patients，12 cases of infant were survival，and 4 cases of infant were dead.15 cases received uterus neoplasty，3 cases underwent hysterectomy，and 5 cases received subtotal hysterectomy.Conclusion：Scarred uterus rupture was 78%，we should carefully handle the full-term delivery of scarred uterus and termination of Mid pregnancy of scarred uterus，and we should be careful with oxytocin，misoprostol preparation for induction of labor.Symptoms of most uterine rupture are typical.The diagnosis is clear combining with the history，signs and Ultrasonic inspection.Exploratory laparotomy should be taken in emergency，and we should select the uterus neoplasty，hysterectomy or subtotal hysterectomy according to the actual situation. 　　Key words Rupture of uterus；Exploratory laparotomy；Scarred uterus 　　2007年1月-2013年12月收治子宫破裂病例23例，现报告如下。 　　资料与方法 　　2007年1月-2013年12月收治子宫破裂患者23例，年龄21～44岁。因晚期妊娠的患者16例，中期妊娠引产的患者7例。23例患者中，瘢痕子宫18例，其中足月妊娠阴道分娩试产8例，妊娠后期自发性子宫破裂3例，瘢痕子宫中期妊娠引产7