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本文通过6个典型病例,介绍了对产后大出血及手术大出血后伤面广泛渗血病人的处理经验。作者认为,产后大出血的主要原因是由于纤溶系统被激活的结果,大量应用纤维蛋白溶酶活性抑制药及皮质激素类药,对治疗此类病人的出血初步收到良好效果。手术大出血后伤面广泛渗血之原因较多,其中主要系纤维蛋白溶酶的被激活,大量输入库存冷血,低血压缺氧等因素,使溶酶体膜遭到破坏致溶酶体酵素向血中释放。大量应用皮质激素类药及抗纤维蛋白溶酶活性药,使库存冷血升温,适当补充钙离子,纠正酸中毒等,对治疗此类病人的伤面广泛性渗血有显著效果。大量应用6—氨基己酸、对羧基苄胺及氢化可的松等类药,尚未见到不良后果。另外也强调指出,调控适当血容量,给洋地黄类药增强心脏功能适当应用血管扩张剂以改善周围循环及预防肾并发症等亦很重要。
This article through 6 typical cases, introduced the postpartum hemorrhage and surgical bleeding after extensive bleeding patients experience. The authors believe that the main cause of postpartum hemorrhage is due to the activation of the fibrinolytic system as a result of extensive use of plasmin-inhibiting drugs and corticosteroids, for the treatment of such patients initially received a good result of bleeding. Surgical bleeding after extensive bleeding wounds are many reasons, of which the main line of plasmin is activated, a large number of imported cold-blooded, hypoxia and other factors, the lysosomal membrane was destroyed due to lysosomal enzymes to Blood release. A large number of application of corticosteroids and antiplasmin active drugs, cold stocking warming, appropriate calcium supplementation, correct acidosis, etc., for the treatment of such patients extensive wound bleeding have a significant effect. A large number of applications 6-aminocaproic acid, carboxybenzylamine and hydrocortisone and other drugs, has not seen any adverse consequences. It is also important to point out that it is also important to regulate proper blood volume, to appropriately apply vasodilators to digitalis to enhance cardiac function, to improve peripheral circulation, and to prevent renal complications.