45例晚期产后出血的临床分析

Clinical analysis of 45 late postpartum hemorrhage cases

目的研究分析导致晚期产后出血的原因,为进一步治疗和预防提供方案。方法选取45例晚期产后出血患者,对其临床资料进行研究探讨。结果胎盘胎膜残留21例(占46.67%),子宫胎盘附着面复旧不良12例(占26.67%),软产道裂伤9例(占20.00%),子宫切口愈合不良3例(占6.67%)。晚期产后出血主要原因是胎盘胎膜残留、子宫胎盘附着面复旧不良、软产道裂伤、子宫切口愈合不良。结论在自然分娩的患者中,胎盘胎膜残留是导致晚期出血的主要因素;对于剖宫产患者,子宫切口愈合不良是导致晚期产后出血的重要因素。临床处理包括抗感染、促进子宫收缩以及手术治疗。

Objective To research and analyze causes of late postpartum hemorrhage, to provide scheme for further treatment and prevention. Methods Clinical data of 45 chosen late postpartum hemorrhage cases were researched and investigated. Results There were 21 cases with retained placenta and foetal membrane(46.67%), 12 cases with uterine placenta adherent surface subinvolution(26.67%), 9 cases with soft birth canal laceration(20.00%), and 3 cases with undesirable healing of uterine incision(6.67%). Main causes of late postpartum hemorrhage included retained placenta and foetal membrane, uterine placenta adherent surface subinvolution, soft birth canal laceration, and undesirable healing of uterine incision. Conclusion Retained placenta and foetal membrane is the main cause of late postpartum hemorrhage in spontaneous labor patients, while undesirable healing of uterine incision is the main cause in cesarean section patients. Clinical management includes antiinfection, uterine contraction promotion and surgical therapy.