“五步快速止血法”治疗剖宫产术中顽固性宫缩乏力产后出血的临床分析  

Clinical analysis of Five-step rapid hemostasis in treating postpartum hemorrhage with intractable uterine contraction in cesarean section

作　　者：郑九生[1] 刘凌芝[1] 沈婷[1] 廖宗高[1] 辛思明[1] 张赟[1] 梁正仪[1] 袁燕[1] 

机构地区：[1]江西省妇幼保健院产科,南昌330006

出　　处：《中华产科急救电子杂志》2017年第1期47-51,共5页Chinese Journal of Obstetric Emergency（Electronic Edition）

摘　　要：目的探讨"五步快速止血法"治疗剖宫产术中顽固性宫缩乏力产后出血的有效性和安全性。方法对2015年7月1日至2016年6月30日在江西省妇幼保健院妇产科就诊的280例剖宫产术中宫缩乏力性产后出血的患者,按照"五步快速止血法"流程实施止血处理,观察止血效果及其安全性。对需要实施"五步快速止血法"全部步骤的12例患者随访至术后42 d。结果 280例剖宫产术中发生宫缩乏力性产后出血患者的止血成功率为98.6%(276/280)。12例实施"五步快速止血法"全部步骤的患者,均止血成功,其中1例术后发生腹腔内出血,经保守治疗术后24 h停止出血,1例术后7 d超声检查提示子宫切口愈合不良,术后42 d复查痊愈,其余患者术后7 d和术后42 d复查均痊愈。结论 "五步快速止血法"是一种简单、快速、有效治疗剖宫产术中顽固性宫缩乏力产后出血的方法。Objective To explore the effectiveness and safety of Five-step rapid hemostasis in the treatment of postpartum hemorrhage with intractable uterine contraction in cesarean section. Methods Two hundred and eighty postpartum hemorrhage cases with intractable uterine contraction during cesarean section,who were admitted in Jiangxi Maternity and Infant Hospital,were implemented Five-step rapid hemostasis process during July 1,2015 to June 30,2016; and the hemostatic effect and safety were observed. Twelve cases that completed Five-step rapid hemostasis were followed up for 42 days. Results The hemostasis success rate of 280 postpartum hemorrhage cases with intractable uterine contraction in cesarean section was 98. 5%（276/280）. The 12 cases that underwent Five-step rapid hemostasis were successful in hemostasis. One case had postoperative intra-abdominal hemorrhage,and recovered after conservative treatment for 24 hours. One case was diagnosed undesirable healing of uterine incision by ultrasound at the seventh day after operation,and was recovered at the forty-second day after surgery.Conclusion The Five-step rapid hemostasis is the simple,rapid and effective treatment for postpartum hemorrhage with intractable uterine contraction in cesarean section.

关 键 词：产后出血 宫缩乏力 剖宫产术 止血技术 

分 类 号：R719.8[医药卫生—妇产科学]