探讨剖宫产术中大出血伴休克的护理配合抢救措施

Study on Nursing and Emergency Measures for Hemorrhea with Shock in Cesarean Section

目的对女性病人剖宫产术中呈现大出血的要素进行探求剖析,并找出相应的预防措施,关于降低大出血具有重要的含义。方法对该院于2013年7月—2014年7月收治的84例剖宫产术病人,进行回忆性的整理和剖析病人的病历和病情以及病人的一般资料,探求病人在剖宫产术中呈现大出血的有关影响要素,并使用有效的预防措施,观察医治作用[1]。结果在所有病人中,宫缩乏力的病人有48例,胎盘因素的病人有28例,子宫切口延伸的病人有4例。通过有效医治后,宫缩乏力的病人医治均成功;胎盘因素的病人除4例因"疤痕子宫、前置胎盘、胎盘植入"致大出血最终抢救无效死亡外,其他医治均成功,子宫切口延伸病人医治均成功。结论术前处理导致宫缩乏力的诱因,产前关于有胎盘前置,胎盘植入者要充沛备血;术中要避免操作不当,当出现大出血时,立即对病人进行药物止血和子宫按摩,宫腔纱布填塞,输血输液补充血容量等,必要时行子宫切除术,以抢救产妇的生命。

Objective To discuss and analyze the causes of hemorrhea of females in cesarean section and find corresponding preventive measures thus reducing hemorrhea. Methods 84 cases of patients with cesarean section admitted and treated in our hospital from July 2013 to July 2014 were selected and the disease history, disease condition and the general data of them were recalled and sorted, the relevant influence factors of hemorrhea in cesarean section of patients were discussed,and the patients were given effective preventive measures, and the treatment effect was observed. Results Of all patients, uterine inertia occurred to 48 cases, placenta factors occurred to 48 cases, uterine incision extension occurred to 4 cases, the patients with uterine inertia and uterine incision extension were treated successfully, the patients with placenta factors were treated successfully except 4 cases who died at last after ineffective emergency due to hemorrhea caused by ＂scarred uterus,placenta previa, placenta implantation’. Conclusion We should deal with the causes leading to uterine inertia before operation and avoid inappropriate operation in operation and give drug hemostasis, uterine massage, intrauterine gauze packing and blood transfusion and infusion for supplementing blood capacity to patients when the hemorrhea occurs to them, and give hysterectomy, if necessary, in order to save lives of delivery women, and the patients with placenta previa and placenta implantation should fully prepare blood before delivery.