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探讨产后出血致子宫切除的原因及处理方法。方法对１９８４年１月～１９９７年１２月在北京医科大学第一医院分娩的２１，８１６例孕妇中因产后出血致子宫切除的１８例患者的情况进行了回顾性分析，总结了其孕期特点、分娩方式、剖宫产适应症、产后出血的原因及子宫切除的并发症。结果产后出血致子宫切除者占分娩人数的０．８３‰。其中阴道分娩５例，剖宫产１３例。行子宫全切术者６例，子宫次全切术者１２例。出血原因为；宫内感染（３３．３％），胎盘植入（２２．２％），前置胎盘（１６．７％），胎盘粘连（１１．１％），胎盘早剥（１１．１％），宫缩乏力（１６．７％），子宫复旧不良（５．５６％）、子宫切除术后无并发症发生。结论子宫切除术是抢救产后大量出血的重要手段，但其对产妇的身心健康有一定影响。产后出血致子宫全切的发生率在剖宫产组中高于阴道分娩组，故应掌握剖宫产指征，降低剖它产率，并加强围产保健，尽量减少产后出血所致的子宫切除术。
To investigate the causes and treatment of hysterectomy caused by postpartum hemorrhage. Methods A retrospective analysis was performed on 18 cases of hysterectomy caused by postpartum hemorrhage among 21,816 pregnant women delivered from January 1984 to December 1997 in the First Hospital of Beijing Medical University. The characteristics of pregnancy during pregnancy were summarized. Mode of delivery, cesarean indications, causes of postpartum hemorrhage, and complications of hysterectomy. Results Postpartum hemorrhage caused by hysterectomy accounted for 0.83 ‰. Including vaginal delivery in 5 cases, 13 cases of cesarean section. Line hysterectomy in 6 cases, subtotal hysterectomy in 12 cases. Intrauterine infection (33.3%), placenta accreta (22.2%), placenta previa (16.7%), placenta accreta (11.1%), placental abruption %), Uterine inertia (16.7%), uterine involution (5.56%), no complications after hysterectomy. Conclusion Hysterectomy is an important method to rescue large amount of postpartum hemorrhage, but it has certain effect on maternal health. Postpartum hemorrhage caused by the incidence of total hysterectomy in the cesarean section than the vaginal delivery group, it should have indications for cesarean section to reduce its rate of dissection, and to enhance perinatal care to minimize postpartum hemorrhage caused by hysterectomy Surgery.