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随着剖宫产率的增高,其并发症也随之增多。剖宫产术产后出血是产科常见的严重并发症,是导致孕产妇死亡的主要原因。其中子宫收缩乏力性出血是最常见的原因,其发生率占产后出血总数70%~80%。如何选择快速、简便、适当的产后出血处理方法 ,一直为产科医生所关注。子宫收缩乏力性产后出血的原因很多:子宫病变、子宫肌纤维过分伸展、子宫肌层水肿及渗出;术前、术中过多使用镇静剂、麻醉剂或子宫收缩抑制剂;孕妇高度紧张、过度疲劳等均可导致子宫收缩乏力,发生产后出血。按摩子宫是治疗子宫收缩乏力性子宫出血最简便、迅速有效的首选止血方法。当剖宫产发生子宫收缩乏力性出血时,持续按摩子宫,联合应用缩宫素加米索前列醇肛内给药,或欣母沛子宫肌注射或深部肌肉注射;当药物治疗无效时,行子宫动脉结扎术、B-Lynch缝合术或纱布填塞术,经上述治疗无效严重产后出血,及时行子宫切除术。有条件且要求保留子宫的可行介入治疗。
With the increase of cesarean section rate, its complications also increased. Cesarean section postpartum hemorrhage is a common serious obstetric complication, is the leading cause of maternal death. One of the most common causes of uterine atony bleeding, the incidence of postpartum hemorrhage accounted for 70% to 80% of the total. How to choose fast, simple, appropriate postpartum hemorrhage treatment, has been of concern to obstetricians. Uterine atony Postpartum hemorrhage for many reasons: uterine lesions, uterine muscle fiber over-stretched, myometrial edema and exudation; preoperative and postoperative excessive use of sedatives, anesthetics or uterine contractility inhibitors; pregnant women, high tension, fatigue, etc. Can lead to uterine atony, postpartum hemorrhage occurs. Massage the uterus is the treatment of uterine atony uterine bleeding the most simple, quick and effective method of choice to stop bleeding. When cesarean section uterine atony bleeding, continuous massage the uterus, combined with oxytocin plus misoprostol intramuscular administration, or Xinmu Pei intramuscular injection or deep intramuscular injection; when the drug treatment is not effective, the line Uterine artery ligation, B-Lynch suture or gauze packing, after the treatment of ineffective severe postpartum hemorrhage, timely hysterectomy. Feasible and requires a viable intervention to preserve the uterus.