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目的 讨论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的病人的临床特点及方法。结果 15例患者中子宫切除者 9例 ,行动脉栓塞治疗 7例 (2例切除子宫后又行栓塞治疗 ) ,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 :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。合理的治疗方案是抢救病人生命 ,保留生育功能 ,尽可能减少创伤的关键。
Objective To discuss the reasonable plan of postpartum hemorrhage intervention. Methods The clinical features and methods of 15 patients with severe postpartum hemorrhage treated with interventional therapy were retrospectively analyzed. Results Among 15 cases, 9 cases were treated by hysterectomy, 7 cases were treated by arterial embolization (2 cases were treated by embolization after removal of the uterus) and 1 case was excised by lesion. The causes of postpartum hemorrhage requiring interventional treatment were as follows: DIC, uterine arteriovenous fistula and vascular malformation, placental abnormalities, uterine fibroids and uterine laceration. Conclusion Different causes, locations and nature of postpartum hemorrhage should be selected for reasonable and effective intervention. Reasonable treatment is to save the patient’s life, to retain the reproductive function, minimize the trauma of the key.