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目的探讨胎盘因素所致产后出血的原因及有效防治措施。方法对46例胎盘因素所致产后出血的病例资料进行回顾性分析。结果 46例胎盘因素所致产后出血的情况主要表现在胎盘嵌顿、胎盘剥离不全、胎盘粘连、前置胎盘、胎盘植入等,其中多产史3例,人工流产史9例,剖宫产史16例,肌瘤剔除史5例,高龄产妇(≥35岁)7例。46例患者均首选宫缩剂止血,在药物治疗的基础上仍大出血者联合多种“二线”技术,41例救治成功,5例药物联合多种“二线”技术仍出血不止行子宫切除术。均救治成功,无1例死亡。结论近年来胎盘因素所致产后出血比例越来越高,药物和多种治疗技术联合应用治疗产后出血有效。产后出血重在预防,降低人工流产率及剖宫产率、尽量减少和预防胎盘因素势在必行。
Objective To investigate the causes of postpartum hemorrhage caused by placental factors and the effective prevention and treatment measures. Methods 46 cases of postpartum hemorrhage due to placental factors were retrospectively analyzed. Results 46 cases of postpartum hemorrhage due to placental factors mainly in the placenta incarceration, placental detachment, placenta accreta, placenta previa, placenta accreta, including 3 cases of prolific history, 9 cases of induced abortion, cesarean section History of 16 cases, myomectomy history in 5 cases, older mothers (≥35 years) in 7 cases. 46 patients were the first choice of contraceptives to stop bleeding, bleeding in the treatment based on the combination of a variety of “second line ” technology, 41 cases of successful treatment, 5 cases of drugs combined with a variety of “second line ” technology is still bleeding Hysterectomy. Successful treatment and no one died. Conclusion In recent years, the proportion of postpartum hemorrhage caused by placental factors is getting higher and higher. The combination of drugs and multiple therapeutic techniques is effective in treating postpartum hemorrhage. Postpartum hemorrhage in prevention, reduce the rate of induced abortion and cesarean section, minimize and prevent placental factors is imperative.