剖宫产后腹腔出血患者的早期识别与处理
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夏小溪
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延吉市医院，吉林延吉，133000
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摘要：目的 分析剖宫产后腹腔出血（IAH）早期识别与处理措施。方法 纳入样本（样本量计数）： 剖宫产后IAH 病例（12 例）；来源：我院妇科；病例采样起始时间节点：2022.4.1；病例采样截止时间节点：2024.3.31。分析12例剖宫产患者IAH早期识别情况及处理结果。结果 12例患者腹腔出血量均值（377.18±25.46）ml；阴道出血量均值（78.56±4.13）ml；住院时间均值（15.11±3.12）d。12 例患者中，显效7 例、有效5 例、无效0 例，总疗效为100.00%。12 例患者中，失血性休克发生率25.00%（3/12）；子宫切除发生率16.67%（2/12）；产褥感染发生率33.33%（4/12）；贫血发生率25.00% （3/12）。12例患者处理后生活质量评分（SF-36）较处理前高（P<0.05）。结论 剖宫产后IAH高危因素较多，常见如紧急剖宫产、胎盘因素、首次剖宫产失血量>500 ml、手术困难等，且IAH 发生早期以低血容量、腹胀、少尿等为常见指征，一旦发生需警惕IAH 发生；剖宫产后IAH 确诊后，及时行保守治疗，密切关注患者病情与体征变化，必要时需行手术治疗，以挽救患者生命，改善患者生活质量。
关健词：剖宫产；腹腔出血；腹腔出血量；阴道出血量；生活质量
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Early identification and management of patients with abdominal hemorrhage after cesarean section
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Xiaoxi Xia
Yanji City Hospital, Yanji, Jilin, 133000,China
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Abstract： Objective To analyze the early identification and treatment measures of intra-abdominal hemorrhage (IAH) aftercesarean section. Methods Included samples (sample size count) : Cases of IAH after cesarean section (12 cases); Source: GynecologyDepartment of our Hospital The starting time point for case sampling: April 1, 2022; The deadline for case sampling isMarch 31, 2024. To analyze the early identification and treatment results of IAH in 12 patients undergoing cesarean section.ResultsThe average abdominal hemorrhage volume of the 12 patients was (377.18±25.46) ml. The average vaginal bleeding volumewas (78.56±4.13) ml; The average length of hospital stay was (15.11±3.12) days. Among the 12 patients, 7 cases showedmarked improvement, 5 cases were effective, and 0 cases were ineffective. The total therapeutic effect was 100.00%. Among the12 patients, the incidence of hemorrhagic shock was 25.00% (3/12). The incidence of hysterectomy was 16.67% (2/12). The incidenceof puerperal infection was 33.33% (4/12). The incidence of anemia was 25.00% (3/12). The quality of life score (SF-36)of 12 patients after treatment was higher than that before treatment (P<0.05).Conclusion There are many high-risk factors forIAH after cesarean section. Common ones include emergency cesarean section, placental factors, blood loss in the first cesareansection >500 ml, surgical difficulties, etc. Moreover, in the early stage of IAH occurrence, hypovolemia, abdominal distension,oliguria, etc. are common indications. Once they occur, the occurrence of IAH should be vigilant. After the diagnosis of IAHafter cesarean section, conservative treatment should be carried out promptly. The patient’s condition and vital signs should be closely monitored. If necessary, surgical treatment should be performed to save the patient’s life and improve their qualityof life.
Keywords : Cesarean section Abdominal hemorrhage The amount of abdominal bleeding; Vaginal bleeding volume; Quality of life
参考文献
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