剖宫产术子宫切口感染致晚期出血四例报告

Management of Late Uterine Bleeding Caused by Incisional Infection after Casarean Section

统计7年内剖宫产后子宫切除术18例,其中有4例是剖宫产后晚期出血保守治疗无效而再次行子宫次全切除术,切除子宫标本病理诊断为子宫切口感染。其临床表现为突发性、无痛性及大量反复阴道出血,适时手术可以挽救产母的生命.预防方法为:降低剖宫产率;选择适宜的硬脊膜外麻醉减少切口裂伤;提高缝合技术减少切口感染;使用全身及局部抗生素预防治疗。

This article reviewed 18 hysterectomies after Cesarean section performed in recent seven years. In this series of cases, four patients with pathoiogically confirmed, late uterine bleedings had partial hysterectomies done after failure of conservative treatment. Clinically, late uterine bleeding was characterized by abrupt onset, massive recurrent pain- less vaginal bleeding. Prompt surgical intervention was the only life-saving measure. A dis- cussion regarding the prophylaxis of this condition was given.