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剖腹产术后晚期出血为罕见的严重并发症,本文报告7例均为子宫下段剖腹产,2例切口的一端有动脉出血,曾反复肠线缝合止血。3例刮宫,其中2例刮出坏死组织,后均因反复大出血切除子宫。1例刮出凝血块。4例未刮宫,均保守治愈。本文认为该合并症的发生与子宫切口位置偏低、多层缝合及过多肠线大块组织缝扎以致局部缺血坏死有关,术后贫血为促进因素,继发感染易致血栓脱落而造成大出血。刮宫术不能改善预后,使用大量广谱抗菌素控制感染,辅以输血等支持疗法,可增加保守治愈的机会。
Late caesarean section postoperative bleeding is a rare serious complication, the paper reported seven cases were lower uterine caesarean section, two cases of incision with arterial bleeding, had repeated catgut suture hemostasis. 3 cases of curettage, of which 2 cases of scratch out of necrotic tissue, after repeated bleeding due to repeated resection of the uterus. 1 case scraped clot. 4 cases did not curettage, are conservative cure. This article believes that the incidence of complications and uterine incision position is low, multi-layer suture and excessive intestinal catgut suture tissue caused by ischemia and necrosis, postoperative anemia as a contributing factor, secondary infection caused by thrombus shedding caused Bleeding. Curettage can not improve the prognosis, the use of a large number of broad-spectrum antibiotics to control infection, combined with blood transfusions and other supportive therapy, can increase the chance of conservative cure.