CAJ | 학술논문

目的：探讨紧急子宫切除术在难治性产后出血中的应用及产后出血的高危因素及其防治措施。方法回顾性分析2010~2014年北京市朝阳区妇儿医院12例因难治性产后出血行紧急子宫切除术患者的临床经过及其围产结局。结果12例患者均因失血性休克、弥散性血管内凝血( disseminated intravascular coagulation, DIC),保守性手术效果不佳,行紧急子宫切除术,其中11例为全子宫切除,1例为次全子宫切除；2例出现心跳骤停,均抢救成功,其中1例遗留神经系统后遗症。结论选择恰当的时机施行紧急子宫切除术,不仅可挽救患者生命,也减少或避免了严重并发症的发生。
목적：탐토긴급자궁절제술재난치성산후출혈중적응용급산후출혈적고위인소급기방치조시。방법회고성분석2010~2014년북경시조양구부인의원12례인난치성산후출혈행긴급자궁절제술환자적림상경과급기위산결국。결과12례환자균인실혈성휴극、미산성혈관내응혈( disseminated intravascular coagulation, DIC),보수성수술효과불가,행긴급자궁절제술,기중11례위전자궁절제,1례위차전자궁절제；2례출현심도취정,균창구성공,기중1례유류신경계통후유증。결론선택흡당적시궤시행긴급자궁절제술,불부가만구환자생명,야감소혹피면료엄중병발증적발생。
Objective To explore the emergency hysterectomy for intractable postpartum hemorrhage, as well as the high-risk factors and treatment measures of postpartum hemorrhage. Methods A retrospective analysis was performed in 12 cases who experienced intractable postpartum hemorrhage following emergency hysterectomy in Maternal and Child Hospital of Chaoyang District during Jan 2010 and Dec 2014. Results All 12 cases were performed emergency total hysterectomy for hemorrhagic shock, disseminated intravascular coagulation ( DIC ) or failed in conservative surgery. Among them, 11 cases performed total hysterectomy, 1 cases performed subtotal hysterectomy. 2 cases appeared cardiac arrest and were successfully rescued, but one of them remained nervous system sequelae. Conclusion The implementation of emergency hysterectomy for postpartum hemorrhage at appropriate time can not only save life, but also reduce or even avoid severe complications.