剖宫产术后晚期产后出血的防治

目的探讨剖宫产术后晚期产后出血发生的原因及防治方法．方法回顾性分析近5年发生的剖宫产术后晚期产后出血患者共9例。结果5年中共行剖宫产术3804例，发生晚期产后出血9例，占0．26％。剖宫产术后晚期产后出血多由于子宫伤口裂开、感染等造成。子宫伤口裂开多由于子宫下段切口撕裂、缝合不良、切口位置选择不当所致。感染与多次肛查或阴道检查或者胎膜早破有关。胎盘残留也是剖宫产术后晚期产后出血发生的原因之一。结论剖宫产术后晚期产后出血多因为子宫下段切口撕裂、缝合对住不整齐，预防感染不到位及贫血、低蛋白血症等。治疗应给予抗生素加止血药物缩宫素，或者开腹行子宫伤口裂开修补或子宫切除术。

The Control Method of Late Postpartum Hemorrhage after Cesarean Section

Objective To discuss the reasons and control method of late postpartum hemorrhage after cesarean section. Methods 9 cases suffered late postpartum hemorrhage after cesarean section among the patients retrospectively analyzed in recent 5 years. Results 3804 patients were treated with cesarean section and nine suffered late postpartum hemorrhage with the rote of 0.26 %. Late postpartum hemorrhage after cesarean .section was mainly caused by wound dehiscence of uterine and infection. The wound dehiscence was caused by the incision tear of lower segment of uterine, adverse suture, and improper choice of incision position. Infection was related to multiple anal examinations, vaginal examinations and premature rupture of membranes. Placental remnants was also one of the reasons. Conclusion Late postpartum hemorrhage after cesarean section is mainly caused by wound dehiscence of uterine , adverse suture, infection, placental remnants. Wound dehiscence of uterine should be avoided and incision should be sutured kiherly. Infection, anemia and hypoproteinemia should be prevented. Antibiotics, hemostatic and oxytocin can be used as treatment. Repair operation and hysterectomy can also be carried out.