目的：总结围产期紧急子宫切除术的病因、时机及指征，以期降低围产期紧急子宫切除术的发生。方法回顾性分析本院2006年1月-2011年12月本院分娩总数31104例次中围产期行子宫切除术的53例病例。结果围产期子宫切除率为1.7‰（53/31104），53例中有1例因羊水栓塞并发肝功能衰竭死亡，其余均治愈。53例围产期紧急子宫切除术手术指征：胎盘异常（包括植入胎盘、前置胎盘）20例，羊水栓塞12例，急性脂肪肝5例，子宫破裂5例，宫缩乏力2例，胎盘早剥2例，宫颈癌2例，其他2例。结论围产期紧急子宫切除术仍是治疗难治性产后出血的最后手段，胎盘植入是最主要的手术指征，剖宫产更易引起胎盘植入而导致子宫切除。%Objective To summarize the cause of perinatal hysterectomy, timing and indications, in order to reduce the incidence of peripartum hysterectomy. Methods 53 cases with perinatal hysterectomy in our hospital from January 2006 to December 2011 were retrospectively analyzed. Results The perinatal hysterectomy rate was 1.7‰(53/31104), one case died due to amniotic fluid embolism complicated with liver failure, the rest were cured. 53 cases of peripartum hysterectomy surgical indications:placental abnormalities (including the implantation of the placenta, placenta previa) 20 cases, 12 cases of amniotic fluid embolism, acute fatty liver of five cases of uterine rupture in 5 cases, 2 cases of uterine inertia, placenta early stripping two cases, two cases of cervical cancer, the other had two cases. Conclusion Perinatal emergency hysterectomy is still the last treatment of intractable postpartum hemorrhage, placenta accreta is the most important indications for surgery, cesarean section more likely to cause a result of placenta accreta hysterectomy.
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