产后出血180例临床分析及预防

Clinical analysis on 180 cases of postpartum hemorrhage patients

目的：分析产后出血的原因及处理措施，探讨产后出血的预防与治疗方法，降低产后出血的发生率及死亡率。方法：对我院2008年3月至2010年3月180例产后出血患者的病因及处理方法进行回顾性分析。结果：产后出血原因主要是子宫收缩乏力（152例），其次是胎盘因素（18例），产道损伤（8例）及凝血功能障碍（2例）。其中176例行药物综合治疗（包括清官术），4例行子宫次全切除术后痊愈。结论：产后出血的主要原因是子宫收缩乏力，其次是胎盘因素、产道损伤及凝血功能障碍。大多数产后出血病例可经药物综合治疗和清官术治愈。在非手术治疗无效时，及时果断地选择子宫切除术是抢救患者生命的必要措施。做好产前检查，选择恰当的分娩方式，产程中积极处理宫缩乏力和胎盘滞留，重视合并症的控制，对预防产后大出血有非常重要的意义。

Objective To analyze the clincal reasons and therapeutic measures on post partum hemorrhage disease. Methods Restrospective analysis was made on 180 cases of post partum hemorrhage patients who admitted our hospital from March 2008 to March 2010. Results 152 cases were due to uterineatony, 18 cases were resulted from placental factors, 8 cases due to the trauma in ower genital tract, one case was induced by coagulation dysfuncfion. Among 180 cases, 176 cases were cured with comprehensive medication, including operation for cleaning the uterus, 4 cases accepted uteretomy and were cured. Conclusion The dominant reason of post partum hemorrhage is uterine atony. The second and other reasons are respectively placental fact ors, the trauma in ower genital tract and coagulation dysfunction. Most of post partum hemorrhage can be cured by comprehensive medication and operati on for cleaning the uterus.