剖宫产术子宫收缩乏力性产后出血的治疗进展  

Cesarean section uterine contractions fatigue progress for the treatment of postpartum hemorrhage

作　　者：唐未坤[1] 

机构地区：[1]天津市职业病防治院妇产科,天津300011

出　　处：《中国城乡企业卫生》2015年第4期12-15,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：随着剖宫产率的增高,其并发症也随之增多。剖宫产术产后出血是产科常见的严重并发症,是导致孕产妇死亡的主要原因。其中子宫收缩乏力性出血是最常见的原因,其发生率占产后出血总数70%~80%。如何选择快速、简便、适当的产后出血处理方法 ,一直为产科医生所关注。子宫收缩乏力性产后出血的原因很多：子宫病变、子宫肌纤维过分伸展、子宫肌层水肿及渗出;术前、术中过多使用镇静剂、麻醉剂或子宫收缩抑制剂;孕妇高度紧张、过度疲劳等均可导致子宫收缩乏力,发生产后出血。按摩子宫是治疗子宫收缩乏力性子宫出血最简便、迅速有效的首选止血方法。当剖宫产发生子宫收缩乏力性出血时,持续按摩子宫,联合应用缩宫素加米索前列醇肛内给药,或欣母沛子宫肌注射或深部肌肉注射;当药物治疗无效时,行子宫动脉结扎术、B-Lynch缝合术或纱布填塞术,经上述治疗无效严重产后出血,及时行子宫切除术。有条件且要求保留子宫的可行介入治疗。With the cesarean section rate increased, and its complications has said. Cesarean section postpartum hemorrhage is a common severe obstetric complications, is the leading cause of maternal death. The uterine contractions fatigue hemorrhages are the most common reason, the total number of incidence of postpartum hemorrhage, 70% to 80%. How to choose a fast, simple and appropriate postpartum hemorrhage treatment method, has been the concern of the obstetrician. Uterine contractions fatigue sex postpartum hemorrhage for many reasons ：uterine lesions, uterine muscle fibers overstretch, myometrium edema and seepage; Excessive use of sedatives, preoperative and intraoperative anesthetic or uterine contraction inhibitors;Pregnant women high tension,fatigue, etc all can cause uterine contractions fatigue,in postpartum hemorrhage. Massage the uterus is the treatment of uterine contractions fatigue uterine bleeding is simple,rapid and effective hemostatic method of choice. When cesarean section uterine contractions occur fatigue hemorrhages, continue to massage the uterus, combined use of oxytocin and misoprostol in the anal,mother or hin levon uterine muscle injection or deep muscle injection;When drug treatment is invalid,the line of uterine artery ligation and B-Lynch suture or gauze,through the above treatment is invalid severe postpartum hemorrhage,uterus resection in a timely manner. Conditional and require the uterus feasible interventional treatment.

关 键 词：剖宫产术 子宫收缩乏力 产后出血的治疗 

分 类 号：R714.7[医药卫生—妇产科学]