目前,产后出血仍是产妇死亡的主要原因之一,当产后出血使用一般常规治疗后,仍不能止血者,应一边扩容、输血、改善微循环,一边尽快采用手术方式止血。现将各种常用的手术方法作一介绍。 1 全子宫或次全子宫切除术这是一个有效的止血手术。尤适宜于植入性胎盘、子宫破裂、羊水栓塞、子宫收缩乏力、感染等。决定行子宫或次全子宫切除手术,需要根据出血的部位和产妇的一般情况,如果是子宫下段、子宫颈或阴道撕裂,应行全子宫切除。子宮切除后要注意检查阴道出血点并缝扎止血。手术宜做得快、准,结扎血管要牢。如果手术中出血部位不清或子宫出血剧烈,可以用纱布卷压迫腹主动脉(在腰椎前,肾动脉下方)暂时阻断盆腔及下肢血流,每压10分钟放松半分钟至1分钟,这样既保证了心、脑、肝、肾的主要脏器的血流量,又可减少出血,便于寻找出血点。病员情况危急时,亦可应用此法, At present, postpartum hemorrhage is still one of the main causes of maternal death. When postpartum hemorrhage is treated with general routine treatment, hemostasis should not be stopped. Dilatation, blood transfusion and microcirculation should be adopted while hemostasis should be operated as soon as possible. Now a variety of commonly used surgical methods for an introduction. A total hysterectomy or subtotal hysterectomy This is an effective hemostatic surgery. Particularly suitable for implantable placenta, uterine rupture, amniotic fluid embolism, uterine atony, infection and so on. The decision to line uterus or subtotal hysterectomy surgery, according to the site of bleeding and maternal general situation, if the lower uterine segment, cervix or vaginal tear, hysterectomy should be performed. After hysterectomy should pay attention to check the vaginal bleeding point and suture to stop bleeding. Surgery should be done quickly, accurate, ligation of blood vessels to prison. If the bleeding site during surgery is unclear or severe uterine bleeding, the abdominal aorta can be crimped with gauze (under the lumbar spine and below the renal artery) to temporarily block the blood flow in the pelvic and lower extremities and relax for half a minute to 10 minutes per pressure for 1 minute Not only ensure the heart, brain, liver and kidney of the main organs of blood flow, but also reduce bleeding, easy to find the bleeding point. The patient’s condition is critical, this method can also be applied,