晚期产后大出血58例临床分析

The Clinical Analysis of 58 Patients with Late Postpartum Hemorrhage

目的:探讨晚期产后大出血的发生原因及防治措施。方法:回顾性分析本院1996年1月至2005年1 月收治的晚期产后大出血58例的临床资料。结果:晚期产后大出血主要原因为胎盘、胎膜残留,子宫胎盘附着面感染或复旧不良以及剖宫产术后子宫切口感染、裂开出血。58例患者经过药物及手术治疗均痊愈。结论:采用宫缩素及抗感染、清宫术等对症治疗,对急性出血者可行经皮髂内动脉栓塞术或子宫切除术治疗晚期产后大出血。

Objective：To explore the causes and measures of prevention and treatment of late postpartum hemorrhage. Methods： The clinical data of 58 patients with late postpartum hemorrhage in our hospital from Jan 1996 to Jan 2005 were analyzed retrospectively. Results： The causes of late postpartum hemorrhage were mostly retained placental tissue or membranes, endometritis or deciduitis and uterine incision infection and dehiscence of cesarean section. By medication and surgery therapy, all patients recovered from the illness. Conclusion： The treatment of choice was mainly uterine curettage and the use of oxytocin and antibiotic. The embolization of internal iliac arteries with percutaneous catheter or hysterectomy might be done in some cases with acute excessive bleeding.