产后出血的干预性治疗

摘要

目的讨论产后出血干预治疗的合理方案。方法回顾性分析15例行干预性治疗的严重产后出血的病人的临床特点及方法。结果 15例患者中子宫切除者9例，行动脉栓塞治疗7例（2例切除子宫后又行栓塞治疗），行病灶挖除术1例。需行干预性治疗的产后出血的原因依次为：DIC,子宫动－静脉瘘及血管畸形，胎盘异常，子宫肌瘤及子宫裂伤。结论应针对产后出血的不同原因、部位及性质选择合理有效的干预治疗。合理的治疗方案是抢救病人生命，保留生育功能，尽可能减少创伤的关键。%Objective To review the management of postpartum hemorrhage (PPH). Methods Fifteen cases of severe PPH were retrospectively analyzed for clinical parameters and management. Results Nine patients had a hysterectomy while selective arterial embolization was carried out in 7 cases. One patient had focus clearance. The main causes of postpartum hemorrhage requiring operative management were disseminated intravascular coagulation (DIC), uterine arteriovenous fistula and malformation, placental abnormality, uterine myoma and laceration. Conclusion Upon recognition of postpartum hemorrhage, the most effective management should be initiated. Every effort should be made to stabilize the patient and maintain her reproductive capability.