焦颖++++++付玉静++++++徐采炎

    [摘要] 本文分析了首都医科大学附属北京同仁医院近5年收治的子宫破裂病例4例，其中子宫完全破裂3例，1例为不全破裂，最小周数为25周，最大周数为40+6周。临床表现均较典型，以突然的剧烈腹痛、休克、腹部有压痛、胎心音消失为主，其中剖宫产术后子宫瘢痕破裂1例，子宫肌瘤剔除术后2例，原因不明1例(有人工流产病史)。均进行急诊剖腹探查术及子宫修补术，术后行一系列对症治疗，7 d好转出院。无孕妇死亡病例，胎儿死亡3例。通过对照国内外文献报道，对子宫破裂的发病原因、临床特征及诊治要点进行总结可见瘢痕子宫、宫腔操作损伤是子宫破裂的高危因素。

    [关键词] 子宫破裂；瘢痕子宫；腹腔镜下肌瘤剔除术；孕妇

    [中图分类号] R71 [文献标识码] A [文章编号] 1673-7210(2017)07(c)-0163-04

    [Abstract] The article analyzes 4 cases diagnosed as uterine rupture in recent 5 years at Beijing Tongren Hospital， CMU， including 3 cases of compelete uterine rupture and 1 case of incompelete uterine rupture. Gstational weeks ranging from 25 weeks to 40+6 weeks. 4 cases with the typical syndrome of sudden severe abdominal pain， shock， abdominal tenderness and fetal heart sounds disappeared. Cesarean scar rupture was found in 1 case， myomectomy were found in 2 cases ， unknown cause was found in 1 case (history of artificial abortion).The 4 cases underwent emergency exploratory laparotomy and uterine repair， after a series of symptomatic treatment， improved and discharged within 7 days. No case of maternal death and 3 cases of fetal death. Through comparative study of domestic and foreign literatures ......