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目的探讨剖宫产术中大出血原因及处理方法。方法2004年1月至2005年12月间28例剖宫产术中出血量≥1000ml的临床资料。结果28例主要出血原因为子宫收缩乏力合并胎盘粘连或植入。出血量1000～1500ml者22例;1500～2000ml者4例;>2000ml者2例。经药物和子宫按摩,缝合止血,宫腔内纱条填塞,1例行子宫次全切除,经综合治疗,患者均痊愈出院。结论剖宫产术中出血原因很多,大出血的原因以综合因素者多。主要为子宫收缩乏力合并胎盘粘连或植入,术中加大缩宫素的用量,及时缝合,压迫止血,以及补充血容量等综合治疗可改善患者全身情况,减少子宫切除几率,降低孕产妇病死率。
Objective To investigate the cause of major bleeding in cesarean section and its treatment. Methods Clinical data of 28 cases with blood loss ≥1000ml in cesarean section between January 2004 and December 2005 were analyzed retrospectively. Results The main causes of bleeding in 28 cases were uterine atony and placental adhesion or implantation. Twenty-two patients had a blood loss of 1000-1500 ml, four patients of 1500-2000 ml and two patients> 2000 ml. The medicine and uterus massage, suture hemostasis, intrauterine gauze packing, subtotal hysterectomy in 1 case, the comprehensive treatment, patients were discharged. Conclusion There are many causes of bleeding in cesarean section. The causes of major bleeding are mostly combined factors. Mainly for uterine atony combined with placental adhesion or implantation, surgery to increase the amount of oxytocin, timely suture, oppression, hemostasis, and blood volume and other comprehensive treatment can improve the patient’s general condition, reduce the chance of hysterectomy and reduce maternal mortality rate.