产后出血的干预性治疗

目的：探讨产后出血干预治疗的合理方案。方法：回顾性分析15例行干预性治疗的严重产后出血患者的临床特点及方法。结果：15例患者中子宫切除者9例，行动脉栓塞治疗7例（2例切除子宫后双行栓塞治疗），行病灶挖除术1例。需行干预性治疗的产后出血的原因依次为：弥漫性血管内凝血（DIC），子宫动－静脉瘘及血管畸形，胎盘异常，子宫肌瘤及子宫裂伤。结论：应针对产后出血的不同原因、部位及性质选择合理有效的干预治疗，以抢救患者生命，保留生育功能，尽可能减少创伤。

Optimal Management of Postpartum Hemmorhage

Objective To discuss appropriate management of postpartum hemorrhage(PPH). Material and Methods By means of hospital based data over 10 years, 15 cases of severe PPH were retrospectively analyzed about the clinical parameters and management. Results Among the 15 patients, 9 had hysterectomy, selective arterial embolization was carried out in 7 and 1 had focus clearance. The main causes of postpartum hemorrhage requiring operative management were: DIC, uterine arteriovenous fistula and malformation, placental abnormality, uterine myoma and laceration. Conclusion Upon recognition of postpartum hemorrhage, the most effective management should be initiated. Every effort should be made to stable patient, save life and maintain the reproductive capability.