子宫破裂4例临床分析

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摘要本文分析了首都医科大学附属北京同仁医院近5年收治的子宫破裂病例4例，其中子宫完全破裂3例，1例为不全破裂，最小周数为25周，最大周数为40+6周。临床表现均较典型，以突然的剧烈腹痛、休克、腹部有压痛、胎心音消失为主，其中剖宫产术后子宫瘢痕破裂1例，子宫肌瘤剔除术后2例，原因不明1例（有人工流产病史）。均进行急诊剖腹探查术及子宫修补术，术后行一系列对症治疗，7 d好转出院。无孕妇死亡病例，胎儿死亡3例。通过对照国内外文献报道，对子宫破裂的发病原因、临床特征及诊治要点进行总结可见瘢痕子宫、宫腔操作损伤是子宫破裂的高危因素。

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	焦颖付玉静徐采炎

关键词 ：子宫破裂, 瘢痕子宫, 腹腔镜下肌瘤剔除术, 孕妇

Abstract：The article analyzes 4 cases diagnosed as uterine rupture in recent 5 years at Beijing Tongren Hospital, CMU, including 3 cases of compelete uterine rupture and 1 case of incompelete uterine rupture. Gstational weeks ranging from 25 weeks to 40+6 weeks. 4 cases with the typical syndrome of sudden severe abdominal pain, shock, abdominal tenderness and fetal heart sounds disappeared. Cesarean scar rupture was found in 1 case, myomectomy were found in 2 cases , unknown cause was found in 1 case (history of artificial abortion).The 4 cases underwent emergency exploratory laparotomy and uterine repair, after a series of symptomatic treatment, improved and discharged within 7 days. No case of maternal death and 3 cases of fetal death. Through comparative study of domestic and foreign literatures, on etiology, clinical characteristics, main points of diagnosis and treatment of uterine rupture it can be seen that uteru scar, uterine injuried operations are high risk factors of uterine rupture.

Key words： Uterine rupture Uteru scar Laparoscopic myomectomy Pregnancy

基金资助:首都全科医学研究专项课题（15KQ14）。

通讯作者: 付玉静（1964.4-），女，主任医师，硕士研究生导师；研究方向：围产医学。

引用本文:

焦颖付玉静徐采炎. 子宫破裂4例临床分析[J]. 中国医药导报, 2017, 14(21): 163-166.
JIAO Ying FU Yujing XU Caiyan. Clinical study on 4 cases with uterine rupture. 中国医药导报, 2017, 14(21): 163-166.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I21/163

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