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剖宫产后晚期出血的原因,大多是由于子宫切口愈合不良、感染、坏死及切口裂开所引起,而子宫切口处损伤性动脉瘤形成而引起的出血临床上较少见,文献上也很少有报道,常易误诊为子宫切口坏死。我院曾诊治2例,报道如下。例1.患者26岁,住院号43606。因足月巨大儿于外院行剖宫产术。手术经过顺利,术后阴道出血不多,7天拆线出院。于产后23天、45天、55天3次阴道出血,多于月经量。于1990年1月10日入院。妇科检查:子宫前位,超鸭卵大,双侧附件未见异常。B超:子宫峡部前壁间有一囊性暗区,向宫腔突出,约1.6cm×1.1cm。多普勒探测该区动脉血流频谱与心搏同步。提示:肌间血管池。给予抗炎、止血治疗后,15天后再次复查B超,见囊性暗区明显缩小。阴道血止出院。
The causes of late cesarean section bleeding, mostly due to poor healing of uterine incision, infection, necrosis and incision caused by incision, and uterine incision at the injury caused by aneurysm bleeding is clinically rare, the literature is also very Rarely reported, often misdiagnosed as uterine incision necrosis. Our hospital has treated 2 cases, reported as follows. Example 1. Patient 26 years old, hospital number 43606. Due to a full-term children outside the hospital cesarean section. Surgery passed smoothly, postoperative vaginal bleeding is small, 7 days stitches discharged. In postpartum 23 days, 45 days, 55 days 3 vaginal bleeding, more than the amount of menstruation. January 10, 1990 admission. Gynecological examination: anterior uterus, super duck eggs, bilateral anomalies were not seen. B super: uterine isthmus anterior chamber cystic dark area, prominent to the uterine cavity, about 1.6cm × 1.1cm. Doppler detection of arterial blood flow in this area and heart rate synchronization. Tip: inter-muscular vascular pool. Give anti-inflammatory, hemostatic treatment, 15 days after the re-examination of B-, cystic dark area was significantly reduced. Vaginal blood only discharged.