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目的总结宫腔碘伏纱布填塞治疗剖宫产术中及产后出血的经验。方法选择近4年我院剖宫产术中及产后出血采用宫腔碘伏纱布填塞治疗的118例临床资料进行回顾性分析。按导致出血的原因分成3组,其中宫缩乏力78例,胎盘因素28例,两种因素叠加12例。结果118例中,成功115例,总有效率97.46%。失败的3例中,1例因前置胎盘未能有效结扎活动性出血点,术后3小时行DSA治疗;2例因术中出血量超过2000ml,术后出现低血容量休克及DIC而改行全子宫切除术。本组出血量在800～2500ml,均预后良好,未见宫腔感染及晚期产后出血。结论宫腔碘伏纱布填塞是一种简单有效的治疗剖宫产术中及产后出血的方法。其成功的关键在于早期决断、正确操作。
Objective To summarize the experience of uterine iodophor gauze packing for cesarean section and postpartum hemorrhage. Methods The clinical data of 118 cases who were treated by uterine iodophor gauze packing during cesarean section and postpartum hemorrhage in our hospital in recent 4 years were analyzed retrospectively. The causes of bleeding were divided into 3 groups, including 78 cases of uterine inertia, placental factors in 28 cases, two factors superimposed in 12 cases. Results Among the 118 cases, 115 cases were successful, with a total effective rate of 97.46%. Among the 3 failed patients, DSA was performed in 3 patients 3 days after operation due to the placenta previa and failed to effectively ligate the active bleeding point. Two patients switched to postoperative hemorrhagic volume more than 2000ml, postoperative hypovolemic shock and DIC Hysterectomy. The amount of bleeding in the 800 ~ 2500ml, a good prognosis, no intrauterine infection and late postpartum hemorrhage. Conclusion Intrauterine iodine gauze packing is a simple and effective method of treating cesarean section and postpartum hemorrhage. The key to its success lies in early decision-making, correct operation.