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近20年来,剖宫产率不断上升,已引起了人们的广泛重视。剖宫产术虽对围产儿发病率有所降低,但对产妇的影响不能低估,其中最主要的问题是出血,本文仅就剖宫产术中大出血的防治进行探讨。剖宫产术中大出血的原因与阴道分娩的原因相似,重点在于预防。剖宫产时的接产技术应与阴道分娩相同,胎儿娩出时间仍应按照1-1-1原则,即胎头、胎肩和胎体娩出的时间应相隔一分钟,使子宫肌纤维能逐步缩复保持原有张力,以避免胎盘娩出后因子宫肌纤维收缩和缩复无力而导致产后出血。然后给予宫肌直接注射宫缩剂,等候胎盘自然剥离,此时牵拉脐带旋转胎膜可使完整娩出,宫腔内极少残留组织。助手轻按摩子宫,术者迅速缝合伤口,因为断裂的宫肌往往使收缩减弱或消失,正如子宫破裂时宫缩突
In the past two decades, the rate of cesarean section has been on the rise, which has aroused people’s attention. Although the incidence of perinatal cesarean section has decreased, but the impact of maternal can not be underestimated, of which the most important issue is bleeding, this article only to explore the prevention and treatment of bleeding in cesarean section. The cause of bleeding during cesarean section is similar to that of vaginal delivery, with the focus on prevention. Cesarean section when the delivery of technology and vaginal delivery should be the same, the time of delivery of the fetus should be in accordance with the principle of 1-1-1, that fetal head, shoulder and carcass should be separated by one minute time, so that the uterine muscle fibers can be gradually reduced To maintain the original tension, in order to avoid postpartum hemorrhage due to contractions and shrinkage of uterine muscle fiber after the placenta was delivered. Then give uterine muscle direct injection of uterotonic agents, waiting for placental natural stripping, this time pulling the umbilical cord spin membrane can make the full delivery, minimal residual tissue in the uterine cavity. Assistant light massage the uterus, the surgeon quickly suture the wound, because the rupture of the uterine muscle tend to shrink or disappear, just as uterine rupture when contractions