产后出血的治疗

doi:10.12280/gjfckx.20220269

摘要/Abstract

摘要：

产后出血（postpartum hemorrhage）是我国孕产妇死亡的首要原因,导致产后出血的主要因素有子宫收缩乏力、软产道裂伤、胎盘因素、贫血和凝血功能障碍等。近年来,由于我国生育政策的调整,孕产妇平均年龄逐渐升高,产后出血的发病率和严重程度也呈增长趋势,医疗机构应结合产妇实际情况识别产后出血,注重对产后出血原因的分析和研究,并及时进行预防和采取有效的应对措施,制定个体化治疗策略,保持母体血流动力学稳定,促进子宫收缩,实施适当的外科手术以及恰当的血液制品输注,必要时使用氨甲环酸、重组人活化因子Ⅶ和纤维蛋白原等药物,改善止血,使患者得到及时有效的治疗,降低出血相关死亡率,提高患者生活质量。

关键词: 产后出血, 催产素, 氨甲环酸, 卡前列素氨丁三醇, 米索前列醇, 手术, 输血,自体, 治疗

Abstract:

Postpartum hemorrhage is the leading cause of maternal death in China. The main factors leading to postpartum hemorrhage are uterine atony, genital tract trauma, placental factors, anemia and coagulation dysfunction. In recent years, due to the adjustment of China′s birth policy, the average age of pregnant women has gradually increased, and the incidence and severity of postpartum hemorrhage are also on the rise. Medical institutions should identify postpartum hemorrhage according to the actual situation of the parturient, pay attention to the analysis of the causes of postpartum hemorrhage, take timely prevention and effective countermeasures, and then formulate individualized treatment strategies, maintain the stability of maternal hemodynamics, promote uterine contraction, perform appropriate surgical operations and blood infusion, and drugs such as tranexamic acid, recombinant human activating factor Ⅶ and fibrinogen should be used when necessary to improve hemostasis, so that the patients can receive timely and effective treatment, then reduce bleeding-related mortality, and improve the quality of life of patients in the future.

Key words: Postpartum hemorrhage, Oxytocin, Tranexamic acid, Carboprost tromethamine, Misoprostol, Operation, Blood transfusion, autologous, Therapy

冯强, 张月香. 产后出血的治疗[J]. 国际妇产科学杂志, 2022, 49(5): 574-579.

FENG Qiang, ZHANG Yue-xiang. Treatment of Postpartum Hemorrhage[J]. Journal of International Obstetrics and Gynecology, 2022, 49(5): 574-579.

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