CAJ | 학술논문

目的分析比较2010年、2011年、2012年、2013年四年间在我院行产科急诊子宫切除术病例,探讨如何掌握产科急诊子宫切除术的指征及怎样降低产科急诊子宫切除率.方法回顾性分析我院四年间30例行产科急诊子宫切除术的病例.结果 ①2013年的剖宫产率明显高于2010年、2011年、2012年,但是2013年产科急诊子宫切除率并没有增加;②胎盘因素(70％)是产科急诊子宫切除术的主要指征;③2013年中阴道塞纱术及Bakri球囊填塞术明显高于前三年,差异有统计学意义(x2=1001.36、39.65,P=0.000、0.000);④2013年中产后出血发生率、产科急诊子宫切除率明显低于前三年,差异有统计学意义(x2=16.56、3.26,P=0.000、0.039).结论 ①要预防胎盘异常的发生,来降低产科急诊子宫切除率;②Bakri球囊填塞术可提高产后出血抢救成功率,同时降低转诊率;③阴道塞纱术可降低产后出血率;④降低产后出血率及Bakri球囊填塞术均可降低产科急诊子宫切除率.
목적 분석비교2010년、2011년、2012년、2013년사년간재아원행산과급진자궁절제술병례,탐토여하장악산과급진자궁절제술적지정급즘양강저산과급진자궁절제솔.방법 회고성분석아원사년간30례행산과급진자궁절제술적병례.결과 ①2013년적부궁산솔명현고우2010년、2011년、2012년,단시2013년산과급진자궁절제솔병몰유증가;②태반인소(70％)시산과급진자궁절제술적주요지정;③2013년중음도새사술급Bakri구낭전새술명현고우전삼년,차이유통계학의의(x2=1001.36、39.65,P=0.000、0.000);④2013년중산후출혈발생솔、산과급진자궁절제솔명현저우전삼년,차이유통계학의의(x2=16.56、3.26,P=0.000、0.039).결론 ①요예방태반이상적발생,래강저산과급진자궁절제솔;②Bakri구낭전새술가제고산후출혈창구성공솔,동시강저전진솔;③음도새사술가강저산후출혈솔;④강저산후출혈솔급Bakri구낭전새술균가강저산과급진자궁절제솔.
Objective To compare and analyze the emergency obstetric hysterectomy in the four years from January 2010 to December 2013,so as to master the surgical indications and reduce the incidence of obstetrical emergency hysterectomy.Method We retrospectively analyzed 30 patients admitted in our hospital from January 2010 to December 2013.Results Firstly,the rate of caesarean section in 2013 was obviously higher than those in 2010-2012,but the incidence of the emergency obstetric hysterectomy in 2013 didn' t go up; secondly,the main indications of emergency obstetric hysterectomy were placental factors (70％); thirdly,both the using of plugging the yarn in vagina and the usage rate of Bakri balloon in 2013 were significantly higher than those in the three years from January 2010 to December 2012,(x 2=1001.36,39.65,P=0.000,0.000); fourthly,the incidence of the emergency obstetric hysterectomy and the rate of postpartum hemorrhage in 2013 were both obviously lower those in the three years from January 2010 to December 2012 (x 2=16.56,3.26,P=0.000,0.039).Conclusion Firstly,we should prevent the occurrence of abnormal placenta in order to reduce the incidence of obstetrical emergency hysterectomy; secondly,the use of Bakri balloon could advance the success rate of the rescue of postpartum bleeding,and reduce the referral rate; thirdly,the using of plugging the yarn in vagina could reduce the rate of postpartum hemorrhage; fourthly,the lower rate of the postpartum hemorrhage and the usage of Bakri balloon both could reduce the incidence of obstetrical emergency hysterectomy.