紧急剖宫产子宫切除术的决定因素和并发症：次全子宫切除术与全子宫切除术。

Determinants and complications of emergent cesarean hysterectomy: supracervical vs total hysterectomy.

机构信息

Department of Obstetrics and Gynecology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, MI, USA.

出版信息

Am J Obstet Gynecol. 2010 Sep;203(3):221.e1-5. doi: 10.1016/j.ajog.2010.04.007.

DOI:10.1016/j.ajog.2010.04.007

PMID:20537305

Abstract

OBJECTIVE

We sought to determine whether emergent cesarean supracervical hysterectomy is associated with reduced risk of complications compared to total hysterectomy.

STUDY DESIGN

We conducted a cohort study of 150 women who underwent emergent cesarean hysterectomy at our medical center from 1991 through 2008. We compared the risk factors and indications, and intraoperative and postoperative complications associated with the 2 surgical procedures.

RESULTS

During the study period, a total of 164 cesarean hysterectomies were performed; 91% (n = 150) of these cases were performed emergently of which 53.3% were total and 46.7% were supracervical. There was a significant decline in the relative frequency of total hysterectomy: 71%, 56%, and 24% during 1991-1996, 1997-2002, and 2003-2008, respectively (P < .001). Risk factors, indications for surgery, operative variables, and postoperative complication rates were independent of the type of hysterectomy.

CONCLUSION

Using a cohort of 150 cases from our institution, we found no evidence of increased surgical time or complications associated with total hysterectomy.

摘要

目的

我们旨在确定与全子宫切除术相比，紧急剖宫产式子宫次全切除术是否与降低并发症风险相关。

研究设计

我们对 1991 年至 2008 年间在我们医疗中心接受紧急剖宫产式子宫切除术的 150 名女性进行了队列研究。我们比较了这两种手术的风险因素、适应证、术中及术后并发症。

结果

在研究期间，共进行了 164 例剖宫产式子宫切除术；其中 91%（n=150）为紧急手术，其中 53.3%为全子宫切除术，46.7%为子宫次全切除术。全子宫切除术的相对频率明显下降：1991-1996 年、1997-2002 年和 2003-2008 年分别为 71%、56%和 24%（P<.001）。风险因素、手术适应证、手术变量和术后并发症发生率与子宫切除术的类型无关。