剖宫产术后产后出血602例临床分析

目的：探讨剖宫产术后产后出血的时间、病因及防治措施。方法：对1999-2004年602例剖宫产术后产后出血病进行回顾性分析。结果：发病原因依次为子宫收缩乏力、胎盘粘连、子宫裂伤、子宫切口感染及溃疡、子宫复旧不良、胎盘蜕膜残留和子宫内膜炎。发病时间：早期产后出血系胎儿娩出后24h内；晚期产后出血发生时间以剖宫产术后3w以上占多数。结论：剖宫产术后期产后出血针对出血主要原因应选择快速有效的止血方法；剖宫产术后晚期产后出血不应局限于产褥期内，其主要病因是子宫切口感染、溃疡。对本病的诊断防治值得重视。

Clinical analysis of 602 cases associated with postpartum hemorrhage after cesarean section

Objective:To discuss the occuring time pathogenesis, prevention and management of postpartum hemorrhage after CS. Methods:Clinical data of 602 cases of hemorrhage after CS from 1999 to 2004 were analized retrospectively.Results:The causes of hemorrhage were as follows: uterine atony, factors associated with placenta, uterine laceration, infection of cesarean incrision, subinvolution of uterus, retained placenta or decidua and endometritis infurn. Cases of primary hemorrhage were 24 hours after delivery. Most cases of late-hemorrhage were over 3 weeks after delivery, some even over 6 weeks.Conclusion:Prilmary hemorrhage, the following is important: adopting rapid and effective methods targeting the causes of hemorrhage. Late-postpartum hemorrhage after CS may occur beyond incision. Diagnosis Prevention and treatment afe important.