计划性剖宫产子宫切除术与急诊剖宫产子宫切除术

Planned vs emergent cesarean hysterectomy.

作者信息

Briery Christian M, Rose Carl H, Hudson William T, Lutgendorf Monica A, Magann Everett F, Chauhan Suneet P, Morrison John C

机构信息

Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, USA.

出版信息

Am J Obstet Gynecol. 2007 Aug;197(2):154.e1-5. doi: 10.1016/j.ajog.2007.03.026.

DOI:10.1016/j.ajog.2007.03.026

PMID:17689631

Abstract

OBJECTIVE

The aim of this study was to compare operative and postpartum outcomes between planned and emergent cesarean hysterectomy.

STUDY DESIGN

In this multicenter retrospective review over a 5-year period, 65 cases of cesarean hysterectomy (30 planned vs 35 emergent) were identified. Demographic, operative, and postoperative data were extracted and stratified by group (planned vs emergent).

RESULTS

Patients who underwent an emergent cesarean hysterectomy were more likely to have higher estimated blood loss (2597.1 +/- 1369.4 mL vs 1963.3 +/- 1180.2 mL; P = .05), have transfusion (66% vs 33%; P = .02), and require greater quantities of packed red blood cells (4.49 +/- 4.7 x10(12)/L vs 1.6 +/- 3.1 x10(12)/L; P = .006) compared with the planned cesarean hysterectomy group. Patients who underwent emergent cesarean hysterectomy had higher overall complication rates (37% vs 66%; P = .03) and more intensive care unit admissions (7% vs 29%; P = .03).

CONCLUSION

After planned cesarean hysterectomy, patients had a significantly lower rate of blood loss, less need for blood transfusions, and fewer complications compared with patients who underwent an emergent cesarean hysterectomy.

摘要

目的

本研究旨在比较计划性剖宫产子宫切除术与急诊剖宫产子宫切除术的手术及产后结局。

研究设计

在这项为期5年的多中心回顾性研究中，共纳入65例剖宫产子宫切除术病例（30例计划性手术与35例急诊手术）。提取人口统计学、手术及术后数据，并按组（计划性手术组与急诊手术组）进行分层。

结果

与计划性剖宫产子宫切除术组相比，急诊剖宫产子宫切除术患者的估计失血量更高（2597.1±1369.4毫升 vs 1963.3±1180.2毫升；P = 0.05），输血比例更高（66% vs 33%；P = 0.02），且需要更多单位的浓缩红细胞（4.49±4.7×10¹²/L vs 1.6±3.1×10¹²/L；P = 0.006）。急诊剖宫产子宫切除术患者的总体并发症发生率更高（37% vs 66%；P = 0.03），入住重症监护病房的比例也更高（7% vs 29%；P = 0.03）。