全子宫切除术后阴道残端出血的原因分析与防治

摘要

Objective:To explore the etiology and treatment vaginal stump bleeding after hysterectomy. Methods:Twenty patients of vaginal stump bleeding after hysterectomy from January 2010 to January 2014 were retrospectively analyzed. Re-sults:The reasons of vaginal stump bleeding after hysterectomy are unstable ligation of vascular of stump,infection,melt of ab-sorbable thread and granulation. In addition,low albumin,anemia,diabetes and other complications are related to bleeding. There are 3 cases of active bleeding within 24 h after operation,4 cases of small amount bleeding within 24 h ~ 10 d after oper-ation,and 10 cases of more than 10 d intermittent bloody vaginal discharge. Conclusion:To strength the management of preoper-ative prevention of vaginal stump bleeding:treating of complications before operation,carefully suturing of stump in operation and antibiotic treatment after operation.%目的：探讨全子宫切除术后阴道残端出血原因及防治。方法：对2010年1月—2014年12月行全子宫切除术后并发阴道出血20例进行原因分析。结果：术后24 h 内有活动性出血者3例，术后24 h ~10 d 内少量出血4例，术后10 d 以上阴道间断有血性分泌物13例。患者术后复诊均恢复正常。结论：针对出血原因，术前纠正并发症，术中做好阴道断端的缝合，术后加强抗感染的治疗，以预防子宫全切术后阴道残端发生出血。