经腹子宫全切除术后阴道残端出血12例诊疗方法和体会.docVIP

经腹子宫全切除术后阴道残端出血12例诊疗方法和体会 　　摘要：目的：探讨经腹子宫全切除术后阴道残端出血的原因，并根据不同原因而采取积极有效的应急措施，以减少和控制出血。方法：对我院2008年1月-2013年6月87例经腹子宫全切除术后12例阴道残端出血患者临床资料进行回顾性分析。结果：阴道残端出血原因为血管韧带缝扎不牢、止血不严密、阴道炎性感染及全身状况差如贫血、凝血机制异常等。12例患者根据不同的病因采取有效措施，8例患者延迟3-5d痊愈出院，4例患者出院后转门诊观察治疗10d痊愈，术后3个月、6个月随访，无异常并发症。结论：术前严格监测患者的各种机体参数，正确评价和积极修正患者术前机体素质；术中改羊肠线间断缝合为PGA（金杰）1-0医用带针缝合线平行褥式间断缝合，并加强缝合技巧的培训。术后加强对患者的病情观察，对不同出血原因而采取积极有效的应急措施是减少和控制出血的有效手段。 　　关键词：子宫全切除术；阴道残端出血；诊疗方法与体会 　　Postoperative abdominal hysterectomy vaginal bleeding stump treatment methods and experience of 12 cases 　　Wu Shu-yang 　　Jian yang Town hospitals Jianhu （Yancheng jiangsu） 224751，china 　　[Abstract] Objective： To investigate postoperative abdominal hysterectomy， vaginal bleeding stump reasons and according to different reasons to take positive and effective emergency measures to reduce and control bleeding. Methods： The hospital in January 2008 -2013 in June 87 cases of abdominal hysterectomy vaginal stump bleeding after 12 cases clinical data were retrospectively analyzed. Results： Vaginal bleeding due to vascular ligament stump suture strong， bleeding is not tight， vaginitis infections and poor general condition such as anemia， abnormal blood clotting mechanism. 12 patients according to different causes to take effective measures， eight patients were discharged delay 3-5d， 4 patients discharged from hospital outpatient observation and treatment after the switch 10d healed after 3 months， 6 months follow-up， no abnormal complications.Conclusion： Preoperative strict monitoring of patients with various body parameters， the correct evaluation and actively revising the preoperative quality of the body； intraoperative change catgut interrupted sutures of PGA （Ginger） 2-0 sutures with needles parallel medical mattress intermittent stitching and sewing skills training to strengthen. Strengthen the patients condition after the observation of the different causes of bleeding and take positive and effective emergency measures to reduce and effective m