难治性产后出血16例临床分析

The Clinical Analysis of 16 Cases of Intractable Postpartum Hemorrhage

目的分析难治性产后出血的病因,探讨预防及治疗的各种措施。方法回顾性分析16例难治性产后出血病例的临床资料。结果产后出血的主要原因依次为:胎盘因素12例(合并重度子痫前期1例)、宫缩乏力2例(双胎妊娠、巨大儿1例)、宫颈黏膜撕裂1例、子宫破裂1例。采用改良B-lynch缝合、盆腔血管结扎、宫腔纱布填塞、水囊压迫、介入治疗、子宫切除等方法救治,14例剖宫产,2例阴道分娩,16例难治性产后出血病例均抢救成功。结论难治性产后出血胎盘因素所致更多见,往往需针对不同的原因,联合采用多种不同的止血方式,方可有效预防和治疗难治性产后出血。

Objective To analyze etiologies of intractable postpartum hemorrhage, explore the prevention and treatment measures. MethodB A retrospective analysis of 16 cases of intractable postpartum hemorrhage cases. Results The main reasons of postpartum hemorrhage were： placental factors in 12 cases （1 case with severe preeclampsia）, uterine atony in 2 cases（twin pregnancy, 1 case of macrosomia ）, cervical mucosal tears in 1 case, 1 case of uterine rupture. Using improved B-lynch suture, pelvic vessel ligation, uterine stuffiness gauze, water sac compression, interventional therapy to treat, womb excision method, 14 cases of cesarean section, 2 cases of vaginal delivery, a total of 16 cases of intractable postpartum hemorrhage cases were rescued successfully, Conclusion Placental factors is the main reasons of intractable postpartum hemorrhage. The treatment of intractable postpartum hemorrhage are often required for a variety of methods of hemostasis according to different reasons. It may be effective way to prevention and treatment of intractable postpartum hemorrhage.