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1、分娩期子宫破裂20例临床诊断与治疗席和红（蓬安县人民医院妇产科637800paldj431@163.com）摘要:目的探讨子宫破裂的病因、诊断治疗及预防措施，减少孕产妇及围产儿死亡。方法收集2002～2008年蓬安县人民医院收治的20例分娩期子宫破裂病例，对其临床资料进行回顾性分析。结果不全性子宫破裂8例，完全性子宫破裂12例；导致子宫破裂的病因中，瘢痕性子宫11例，梗阻性难产3例，产前不当使用宫缩剂1例，多次生产5例；死胎8例，死产6例，新生儿存活6例，围产儿死亡率70%（14/20）；9例行子
2、宫破裂修补术，9例行子宫次全切除术，2例行子宫全切术。结论加强产前检查，密切观察产程，避免忽略性难产的发生。有剖宫产史或子宫切开手术史及多次生产者，应提前住院待产，根据指征及前次手术情况决定本次分娩途径，若无梗阻性难产存在，也可在严密观察下经阴道分娩。对缩宫素、前列腺素等子宫收缩剂的使用指征、方法应严格掌握，避免滥用。严格掌握剖宫产及各种阴道手术指征。关键词:分娩期；子宫破裂；瘢痕性子宫；难产；手术治疗Childbirthuterineruptureof20casesofdiagnosisandt
3、reatment.作者简介：席和红女1976年2月14日出生四川广安人妇产科主治医师大学学历擅长妇产科(DepartmentofobstetricsandGynecology,PenganCountypeople'shospital,pengan,637800,China)Abstract:ObjectiveToinvestigatethecauseofuterinerupture,diagnosis,treatmentandpreventionmeasurestoreducematernalan
4、dperinataldeaths.MethodsFrom2002to2008inourhospitaladmitted20casesofuterineruptureduringchildbirthcases,theclinicaldatawereconstructionqualityacceptanceandassessmentRegulation(ProfessionalEdition)(DL/T5210.2-2009~DL/T5210.8-2009);1.9thequalitycheckout
5、andevaluationofelectricequipmentinstallationengineeringcode(DL/T5161.1-2002~5161.17-2002);1.10thenormsofconstructionsupervision,theelectricpowerconstructionsupervisionregulations7retrospectivelyanalyzed.Results8casesofincompleteuterinerupture,12caseso
6、fcompleteuterinerupture;leadingcausesofuterinerupturein11casesofuterinescar,threecasesofobstructivedystocia,improperuseofprenataluterineagentin1case,multipleproductionof5cases;8casesoffetaldeath,6casesofstillbirth,neonatalsurvivalin6cases,perinatalmor
7、talityof70%(14/20);9casesofuterinerupturerepair,9routinehysterectomyoperation,2casesofuterineFullresection.ConclusionTostrengthenprenatalcare,andcloselyobservetheproductionprocess,toavoidtheoccurrenceofneglecteddystocia.Thereishistoryofcesareansection
8、oruterineincisionhistoryandmultipleproducers,shouldbeproducedinadvancetobehospitalized,accordingtoindications,andprevioussurgeriesdecidedtoorganizethedeliverymeans,intheabsenceofobstructivedystociaexist,canalsobeundercloseobservationaftervagin
