剖宫产术中大出血的处理(附109例分析)

Management of Intraoperative Massive Hemorrhage of Cesarean Section ( with A Report of 109 Cases)

目的探讨剖宫产术中大出血原因及其处理方法. 方法回顾性分析2001年1月～2003年1月109例剖宫产术中出血量≥5 00 ml的临床资料、处理方法及治疗效果. 结果 65例经药物和子宫按摩后止血,应用血管缝扎+子宫修补16例,子宫动脉结扎17例,宫腔内纱布填塞6例,子宫次全切除5例,患者均痊愈出院. 结论药物和子宫按摩对大部分宫缩乏力引起的剖宫产大出血有效,对难治性大出血应果断地行手术处理.

Objective To investigate the causes and mana ge ment of intraoperative massive hemorrhage of cesarean section. Metho d 109 cases of cesarean with blood loss over 500 ml admitted from Ja nuary 2001 to January 2003 were retrospectively reviewed with regard to bleeding causes, treatment and effectiveness. Result Hemostasis was achieved by medication and uterine massage in 65 cases, uterine repair and l igation in 16 cases, uterine artery ligation in 17 cases, intrauterine gauze pac king in 6 cases and subtotal hysterectomy in 5 cases. All patients discharged wi thout symptom. Conclusion Intraoperative massive hemorrh age of cesarean section due to uterine inertia can be cured by medication and ut erine massage in most cases, and surgical treatment should be selected without h esitation in case the bleeding is uncontrollable.