摘要
产后出血(PPH)是分娩期严重并发症,其中由于子宫收缩乏力所致PPH最为常见。近年胎盘因素,如前置胎盘、胎盘植入等发生率呈逐年增高趋势,从而导致PPH发生率增加。前置胎盘、胎盘植入等可采用多种辅助检查手段(超声、MRI、膀胱镜)尽早确诊,评估病情,制定个体化治疗方案,从而降低PPH发生率。最新研究认为,国家全面两孩政策开放及剖宫产术后再次妊娠选择经阴道分娩,可能增加胎盘因素引起的PPH发生率。临床对于PPH的诊断,不仅应依据分娩时的失血量,还需重视产妇血流动力学改变。目前采用药物治疗、手术治疗、介入治疗等PPH个体化治疗策略,均取得较好临床疗效。笔者拟就PPH的病因、诊断及治疗的最新研究进展,进行综述如下。
Postpartum hemorrhage(PPH)is a serious complication during delivery,and PPH caused by uterine contraction fatigue is the most common kind of PPH.In recent years,the incidence of placenta factors,such as of placenta previa and placenta increta,has been increasing year by year,resulting an increase in the incidence of PPH which can be diagnosed as early as possible via varieties of auxiliary examination means(ultrasound,MRI,cystoscope),to evaluate the pathogenetic conditions and develop individualized therapy strategies,thereby reducing the incidence of PPH.Recent studies on the pathogenesis of PPH suggest that the Universal Two-Child Policy in China and choice of vaginal delivery after cesarean section may increase the incidence of PPH caused by placental factors.For the diagnosis of PPH,the most recent method is not only based on the volume of blood loss during delivery,but also on hemodynamic changes.Currently,the individualized treatment of PPH with strategies of drug therapy,surgical treatment and interventional therapy have achieved good clinical efficacy.The article focuses on the latest advances in etiology,diagnosis and treatment of PPH.
作者
吴雅娟
单委
蒋敏
卢丹
Wu Yajuan;Shan Wei;Jiang Min;Lu Dan(Medical College of Yangzhou University,Yangzhou 225001,Jiangsu Province,China)
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2018年第6期740-744,共5页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
江苏省卫生计生委妇幼健康科研项目(F201663)~~
关键词
产后出血
胎盘异常
胎盘早剥
前置胎盘
胎盘
侵入性
介入治疗
产科外科手术
产妇
Postpartum hemorrhage
Abnormal placenta
Abruptio placentae
Placenta previa
Placenta accreta
Intervention treatment
Obstetric surgical procedures
Parturient
