宫缩乏力性产后出血的诊治进展

Progress in diagnosis and treatment of postpartum hemorrhage due to uterine inertia

产后出血是产科常见的并发症,是产妇死亡的重要原因。目前产后出血是临床产妇生产过程中最为关注的并发症之一,并且也是产后42 d关注的重点,尤其是那些隐蔽性产后出血最为危险,也是产后复查的重点。有研究认为红细胞压积减少10%者就需要进行相应的止血或输血治疗。目前研究显示导致产后出血的原因较多,主要涉及子宫松弛、收缩乏力、软产道损伤或者胎盘及凝血功能障碍等。若不能及时控制出血,将会增加产妇死亡风险。一旦确诊为宫缩乏力性产后出血,应尽早给予药物,比如缩宫剂或相关中药等,并对于出血较多者给予宫腔填塞,对伤口进行缝合等,从而达到止血目的。本文对宫缩乏力性产后出血的诊断及治疗现状进行综述,以期对宫缩乏力性产后出血的诊治提供参考,进而改善该病的治疗预后。

Postpartum hemorrhage is the common complication in obstetrics and an important cause of maternal death.At present,postpartum hemorrhage is one of the most concerned complications in the process of clinical delivery,and it is also the focus of attention within the 42 days after delivery.Especially,hidden postpartum hemorrhage is the most dangerous,which is also the focus of postpartum reexamination.Some studies believe that those with 10%reduction in hematocrit need corresponding hemostasis or blood transfusion treatment.At present,research shows that there are many causes of postpartum hemorrhage,mainly involving uterine relaxation,weakness of contraction,soft birth canal injury or placenta and coagulation dysfunction.If the bleeding cannot be controlled in time,it will increase the risk of maternal death.Once the diagnosis of postpartum hemorrhage due to uterine inertia is confirmed,drugs should be given as soon as possible,such as uterine contractions or related traditional Chinese medicine,and those with more bleeding should be given uterine cavity tamponade,and the wound should be sutured,so as to achieve the purpose of hemostasis.This article reviews the status of the diagnosis and treatment of uterine inertia postpartum hemorrhage,in order to provide reference for the diagnosis and treatment of uterine inertia postpartum hemorrhage and improve the treatment prognosis of the disease.