晚期产后出血37例临床分析

目的探讨晚期产后出血的病因及防治。方法回顾性分析37例晚期产后出血的临床资料，并与同期100例正常产妇进行比较。结果晚期产后出血的主要原因依次为胎盘、胎膜残留，子宫复旧不良合并子宫内膜炎，子宫切口感染裂开及阴道切口感染裂开。晚期产后出血者中曾行人流或清宫术比例较高。结论人流或清官术是发生晚期产后出血的危险因素之一。晚期产后出血治疗以清官为主，急性出血可行髂内动脉结扎术或经皮髂内动脉栓塞术。必要时行子宫全切术。

Clinical Analysis of 37 Cases of Late Postpartum Hemorrhage

Objective To investigate the etiology, prevention and management of late postpartum hemorrhage. Methods We retrospectively analyzed the clinical data of 37 cases of the late postpartum hemorrhage ,and compared with 100 cases of nomal lying-in women. Results The main causes of late postpartum hemorrhage were retained placenta and membranes, endometritis and decidualitis, subinvolution of uterus ,infection dehiscence and hemorrhage of caesarean incision and vagina incision. The proport of artificial abortion and suction curettage was high among the late postpartum hemorrhage patients. Conclusion The artificial abortion and suction curettage were risk factors of the late postpartum hemorrhage.The first choice of treating the late postpartum hemorrhage is curettage.Acute hemorrhage can be controlled by ligation of internal iliac artery, transcutaneous internal lilac artery embolization, and total hysterectomy if necessarily.