首都医科大学学报 ›› 1986, Vol. 7 ›› Issue (3): 210-213,216,250.

• 论著 • 上一篇    下一篇

剖腹产术后晚期出血(附7例报告)

夏恩兰, 彭雪梅   

  1. 北京市复兴医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:1986-07-15 发布日期:1986-07-15

Late Postpartum Hemorrhage Following Caeserean Sectioh(Report of 7 Cases)

Xia Enlan, Peng Xuemei   

  1. Beijing Fu Xing Hospital
  • Received:1900-01-01 Revised:1900-01-01 Online:1986-07-15 Published:1986-07-15

摘要:

剖腹产术后晚期出血为罕见的严重并发症,本文报告7例均为子宫下段剖腹产,2例切口的一端有动脉出血,曾反复肠线缝合止血。3例刮宫,其中2例刮出坏死组织,后均因反复大出血切除子宫。1例刮出凝血块。4例未刮宫,均保守治愈。本文认为该合并症的发生与子宫切口位置偏低、多层缝合及过多肠线大块组织缝扎以致局部缺血坏死有关,术后贫血为促进因素,继发感染易致血栓脱落而造成大出血。刮宫术不能改善预后,使用大量广谱抗菌素控制感染,辅以输血等支持疗法,可增加保守治愈的机会。

Abstract:

Late postpartum hemorrhageis a rare and severe complication. 7 cases are reported in this article. In all cases lower uterine segment transvere incision was performed. In 2 cases arterial bleeding at one end of the incision wound was checked by repeated sutures with catgut D&C. was done in 3 cases in two of them necrotic tissues were found and subtotal hysterectomies were performed, later because of repeated profuse bleeding from the uterus. Some clots were found in the other case. In 4 cases patients were cured by mere conservation therapy. instead of D&C. The author believed that the complication might be due to a too low uterine incision and too much tissues caught in catgut sutre with an end-result of local necrosis. Post-operative constitutes a promoting factor.D&C can not exert beneficial effect to the outcome. It can be increased in cure rate for conservation therapy applying the larger amount of broadspectrnm antibiotic to control infection, with assistant supporting therapy in transfusion and so on.