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胎儿娩出后24h内出血量超过500mL者为产后出血(postpartum hemorrhage)。常见原因有子宫收缩乏力、胎盘滞留、产道损伤及凝血机制障碍。产后出血是分娩期的严重并发症,是产妇死亡的重要原因之一,在我国居产妇死亡原因的首位。其发生率约占分娩总数的2%~3%,80%以上发生在产后2h之内。产后出血的预后随失血量、失血速度及产妇体质不同而异。短时间内大量失血可迅速发生失血性休克,严重者危及产妇生命,休克时间过长可引起脑垂体缺血坏死,继发严重的腺垂体功能减退一席汉综合征(Sheehansyndrome)。因此应特别重视产后出血的防治与护理工作,以降低产后出血的发生及孕产妇的死亡率。产后出血可发生于胎盘娩出前或后,临床表现短期内大量急性出血,产妇迅速出现失血性休克。如为少量持续性出血或宫腔积血,当失血量达到机体不能代偿时出现休克症状,产妇可表现头晕、面色苍白、出冷汗、烦躁不安、不断打呵欠、恶心、呕吐、脉搏细快、呼吸急促及血压下降等。
Postpartum hemorrhage occurred in more than 500 mL of bleeding within 24 hours after delivery of the fetus. Common causes of uterine atony, placental retention, birth canal injury and coagulation disorders. Postpartum hemorrhage is a serious complication of childbirth, is one of the important causes of maternal death, the leading cause of maternal death in China. The incidence of about 2% to 3% of total delivery, 80% occurred within 2h after delivery. The prognosis of postpartum hemorrhage with blood loss, blood loss and maternal physical differences vary. A large number of blood loss in a short period of time can be rapid hemorrhagic shock, severe maternal life-threatening, shock time can cause pituitary ischemia and necrosis, severe secondary hypopituitarism Han syndrome (Sheehansyndrome). Therefore, special attention should be paid to postpartum hemorrhage prevention and care work to reduce the incidence of postpartum hemorrhage and maternal mortality. Postpartum hemorrhage can occur in the placenta before or after delivery, a large number of acute clinical manifestations of acute bleeding, maternal rapid hemorrhagic shock. Such as a small amount of persistent hemorrhage or uterine hemorrhage, when the blood loss reached the body can not be compensated when the symptoms of shock, the woman can show dizziness, pale, out of cold sweat, irritability, yawning, nausea, vomiting, pulse fine , Shortness of breath and blood pressure drop.