178例剖宫产产后出血病例分析

Analysis of 178 postpartum hemorrhage cases in caesarean section

目的探讨剖宫产产后大出血的原因,分析相关高危因素,以减少剖宫产大出血的发生率。方法回顾分析178例剖宫产产后大出血患者的临床资料。结果 109例发生子宫收缩乏力性出血,62例发生胎盘植入大出血,7例系宫缩乏力合并胎盘植入;54例经一线治疗成功止血,87例经各种二线治疗成功止血,37例切除子宫,无死亡产妇。结论宫缩乏力、前置胎盘、胎盘植入仍是产后出血的主要原因,积极的一、二线治疗可降低子宫切除率,提高产妇的远期生活质量。

Objective To investigate causes of postpartum massive hemorrhage of caesarean section, and to analyze related factors, in order to reduce incidence of massive hemorrhage of caesarean section. Methods Clinical data of 178 patients with postpartum massive hemorrhage of caesarean section were retrospectively analyzed. Results There were 109 cases with uterine inertia hemorrhage, 62 cases with placenta implantation massive hemorrhage, and 7 cases with uterine inertia complicated with placenta implantation. There were 54 cases received first-line treatment for successful hemostasis, 87 cases received second-line treatment, and 37 cases received hysterectomy, and no death cases. Conclusion The main causes of postpartum hemorrhage include uterine inertia, placenta previa, and placenta implantation. Implement of active first-line and second-line treatment can reduce hysterectomy rate and improve long-term life quality of puerperal.