产后严重出血18例临床分析  

Clinical analysis of 18 cases with severe postpartum hemorrhage

作　　者：陈惠萍[1] 朱月华[1] 曹卉[1] 

机构地区：[1]解放军第97医院妇产科,江苏徐州221004

出　　处：《临床军医杂志》2011年第5期962-964,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨产后严重出血的临床特点及治疗方法。方法对1986年12—2010年12月的18例产后严重出血病例的临床资料进行回顾性分析。结果本组病例出血量2 000～8 000 ml。7例产后DIC患者以分娩后子宫出血不凝伴低血压及肾功能衰竭为主要特征,其中2例在产后数分钟内出现胸闷、呼吸困难及心搏骤停。11例有失血性休克,伴有不同程度的凝血及器官功能障碍。经心肺复苏、抗休克、纠正凝血功能障碍、手术止血等处理,抢救成功15例,死亡3例。结论重视对高危妊娠的防治,积极抗休克,早期诊断产科DIC并合理使用肝素,掌握子宫切除的指征和时机,采用有效的止血方法,注意补充凝血因子是提高救治成功率的关键。Objective To analyze the clinical characteristics and effective treatments of severe postpartum hemorrhage. Methods 18 cases with severe postpartum hemorrhage and their clinical data from December 1987 to December 2010 were retrospectively analyzed. Results This group of cases presented with heavily bleeding 2 000 to 8 000ml.7 cases of postpartum DIC patients presented with the main characteristics of no-coagulating uterine bleeding with low blood pressure and renal failure after childbirth.2 cases presented with chest tightness,dyspnea and cardiac arrest within minutes after childbirth.Another 11 patients had hemorrhagic shock accompanied by different levels of blood coagulation and organ dysfunction.After the cardiopulmonary resuscitation,resistance to shock,correcting coagulant function obstacle,surgical hemostatic processing,15 cases were rescued successfully,3 cases dead. Conclusion The key of improving success rate is to attach importance to high-risk pregnancy prevention,positive antishock treatment,early diagnosis and reasonable use obstetric DIC heparin,grasps the hysterectomy indications and timing methods of uterine artery embolization bleeding,and pay attention to complement coagulation factors.

关 键 词：产后严重出血 弥漫性血管内凝血 诊断 治疗 

分 类 号：R714.461[医药卫生—妇产科学]