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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637800paldj431a)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例行子宫破裂修补
2、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Childbirthuterineruptureof20casesofdiagnosisandtreatment・】(
3、DepartmentofobstetricsandGynecology,PenganCountypeople7shospital,pengan,637800,China)Abstract:ObjectiveToinvestigatethecauseofuterinerupture,diagnosis,treatmentandpreventionmeasurestoreducematernalandperinataldeaths・MethodsFrom2002to2008inourhospitaladmitte
4、d20casesofuterineruptureduringchildbirthcases,theclinicaldatawereretrospectivelyanalyzed・Results作者简介：席和红女1976年2月14Fl出生四川广安人妇产科主治医师大学学历擅长妇产科8casesofincompleteuterinerupture,12casesofcompleteuterinerupture;leadingcausesofuterinerupturein11casesofuterinescar,t
5、hreecasesofobstructivedystocia,improperuseofprenataluterineagentin1case,multipleproductionof5cases;8casesoffetaldeath,6casesofstillbirth,neonatalsurvivalin6cases,perinatalmortaiityof70%(14/20);9casesofuterinerupturerepair,9routinehysterectomyoperation,2case
6、sofuterineFul1resection.ConclusionTostrengthenprenatalcare,andcloselyobservetheproductionprocess,toavoidtheoccurrenceofneglecteddystocia・Thereishistoryofcesareansectionoruterineincisionhistoryandmultipleproducers,shouldbeproducedinadvancetobehospitalized,ac
7、cordingtoindications,andprevioussurgeriesdecidedtoorganizethedeliverymeans,intheabsenceofobstructivedystociaexist,canalsobeundercloseobservationaftervaginaldelivery.Pairsofoxytocin,prostaglandinandotheragentsuseduterinecontractionindications,methodsshouldbe
8、strictlycontrolledtopreventabuse・Strictcontrolofcesareansectionandvaginalsurgeryavarietyofindications・Keywords:Childbirth;uterinerupture;uterinescar;dystocia;surgicaltreatment子宫破裂是指子宫体部或子宫一段于分娩期或妊娠末期发生
