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患者车某24岁,1996年4月13日因产后第6天突然发现右侧大阴唇处有肿物、疼痛,入院诊治.既往健康,孕2产2,于1996年4月7日在我院顺产一健康男婴,总产程4.5h.产后便秘,产后第5天第一次药物排便.于产后第6天在给新生儿喂奶时觉右侧大阴唇部疼痛,发现有一鸡蛋黄大小的肿物、触痛.口服消炎药,肿物继续增大,疼痛加剧,前来我院就诊,收住院.查体;一般状态良好,神清语明,饮食正常,面色略黄,全身皮肤无出血点及淤斑.查血:血色素10.5g/L,红细胞3.4×10~(12)/L,白细胞11.0×10~9/L,中性88%,淋巴12%,BT 1min 40s、CT 2min.妇科检查:右侧大阴唇巴氏腺处有约4.0×4.5cm~2肿物,活动性欠佳,质硬、边界清楚、触痛明显、无波动感,阴道前庭充血、有炎性分泌物,阴道粘膜充血,阴道内有炎性分泌物,子宫复旧正常.局麻下,行巴氏腺切开术.见整个腺腔内均是凝固的血块及极少量的暗红色血液.清理囊腔后,腔内继续有血液缓慢流出,用连续交锁缝合法缝合切口四周,敞开腺腔,发现腔内仍然向外流血,检查发现血系由腺腔前下方的囊壁静脉流出后流入腺腔.即在出血部缝合止血,出血停止.给予抗炎、抗贫血治疗.术后7天痊愈出院.讨论:根据病史及检查结果,考虑造成产后巴氏腺血肿的原因可能是:①妊娠晚期,子宫增大,静脉压增高,先露部压迫及内分泌?
A 24-year-old patient car, April 13, 1996 suddenly found on the right side of the labia majora at the sixth day postpartum at the tumor, pain, admission diagnosis and treatment. Past health 2 pregnancy 2, on April 7, 1996 at me The birth of a healthy baby boy hospital, the total 4.5h. Postnatal constipation, the first postnatal day 5 drug defecation .In the 6th day after giving birth to the newborn when the right labia majora pain and found that there is a chicken egg yolk size Tumor, tenderness. Oral anti-inflammatory drugs, the tumor continues to increase, the pain intensified, came to our hospital for treatment, admitted to hospital. Physical examination; general state of good, clear language, normal diet, pale yellow, Bleeding point and ecchymosis.Check blood: hemoglobin 10.5g / L, erythrocyte 3.4 × 10-12 / L, white blood cells 11.0 × 10 ~ 9 / L, neutral 88%, lymphatic 12%, BT 1min 40s, CT 2min . Gynecological examination: the right labia majorandiasis about 4.0 × 4.5cm ~ 2 tumor, poor activity, hard, clear boundary, tenderness, no fluctuations, vaginal vestibule congestion, inflammatory secretion Things, vaginal mucosal congestion, inflammation of the vagina secretions, uterine involution of normal. Local anesthesia, the line of Papanicolaou suture. See the entire gland cavity are solidified blood clots and a very small amount of dark red blood. Cavity After the cavity continued to flow slowly out of blood, with continuous locking suture around the incision, open the gland cavity and found that the cavity is still bleeding, check the blood line from the anterior gland cavity wall venous outflow into the glandular cavity . That is bleeding in the Department of suture hemostasis stop bleeding given anti-inflammatory and anti-anemia .After 7 days cured.Discussion: According to medical history and examination results, consider the cause of postpartum hemorrhage may be: ① pregnancy late, Increased uterus, venous pressure increased, the first Department of oppression and endocrine?