106例剖宫产术产后出血的分析

目的：总结剖宫产术产后出血的原因及处理方法。方法：回顾性分析1992～1997年，我院剖宫产产后出血106例（A组），并与同期阴道分娩产后出血213例（B组）进行比较。结果：A组产后出血的发生率（7．29％）明显高于B组（3．15％）（P＜0．01）；A组产后出血量的严重程度（＞900ml）明显高于B组（P＜0．01）。A组病人产后出血的主要原因为：子宫收缩乏力（80％）、前置胎盘（10．4％）、子宫切口撕裂（3．7％）。A组11例严重产后出血病人采用宫腔纱条填塞术止血，均成功止血。结论：我们认为，应该降低剖宫产率，以减少产后出血的发生率。宫腔无菌纱条填塞是剖宫产术严重产后出血的有效处理手段。

Analysis of 106 Cases of Patients with Postpartum Hemorrhage during the Cesarean Section

Objective: To summarize the main cain and management of postpartum hemorrhage during ce-sarean section. Methods: 106 cases of patients(group A) with postpartum hemorrhage during cesareansection admitted from 1992-1997 were analyzed retrospectively, and compared with 213 cases of pa-tients (group B) with postpartum hemorrhage via vaginal delivery in the same period. Results: Themorbidity of postpartum hemorrhage in group A patients (7. 29%) was much higher than that ingroup B patients(3. 15%) (P<0.01), and the frequency of severe (>9000ml) postpartum hemor-rhage in group A was significantly greater than that in group B(P < 0.01 ). The main causes ofpostpartum hemorrhage in group A patients were failure of retraction of the utere (80%), placentapreviva~ (10.4%), and lacerated cut of the uterus (5. 7%). The treatment of 11 patients with severepostpartum hemorrhage in group A was performed successfully by filling cavum uteri with sterilegauze. conclusion: Based on the above analysis, the rate of cesarean section should be decreased to re-duce the morbidity of postpartum bleeding, and the method of filling cavum uteri with sterile gauze iseffective for severe postpartum hemorrhage during cesarean section.