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中华产科急救电子杂志 ›› 2022, Vol. 11 ›› Issue (03) : 148 -151. doi: 10.3877/cma.j.issn.2095-3259.2022.03.006

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产后出血时血液系统的变化及处理
李亚楠1, 马玉燕1,()   
  1. 1. 250012 济南,山东大学齐鲁医院妇产科
  • 收稿日期:2022-03-03 出版日期:2022-08-18
  • 通信作者: 马玉燕

Changes and managements of the hematologic system during postpartum hemorrhage

Yanan Li1, Yuyan Ma1()   

  • Received:2022-03-03 Published:2022-08-18
  • Corresponding author: Yuyan Ma
引用本文:

李亚楠, 马玉燕. 产后出血时血液系统的变化及处理[J]. 中华产科急救电子杂志, 2022, 11(03): 148-151.

Yanan Li, Yuyan Ma. Changes and managements of the hematologic system during postpartum hemorrhage[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2022, 11(03): 148-151.

产后出血是我国孕产妇死亡的主要原因之一。产后出血时血容量减少,血红蛋白水平下降,严重时可发生失血性休克及凝血功能障碍。根据产后出血时血液系统的变化特点,尽早进行液体复苏、输血及相应病因处理,可提高产后出血救治率。

Postpartum hemorrhage (PPH) is one of the major causes of maternal mortality in our country. During postpartum hemorrhage, blood volume and hemoglobin level drop. Hemorrhagic shock and coagulopathy occur when it aggravates. Based on the characteristics of the hematologic system during postpartum hemorrhage, early fluid resuscitation, blood transfusion and treatments according to related etiologies can improve the clinic level of postpartum hemorrhage in China.

[1]
刘兴会. 产后出血预防与处理指南(2014)[J]. 中华妇产科杂志201449(9):641-646.
[2]
American College of Obstetricians and Gynecologists. Practice Bulletin No. 183: Postpartum Hemorrhage[J]. Obstet Gynecol, 2017130(4):e168-e186.
[3]
Woman Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial [J]. Lancet, 2017389(10084):2105-2116.
[4]
Cannon JW. Hemorrhagic Shock[J]. N Engl J Med, 2018378(4):370-379.
[5]
Kozek-Langenecker SA, Ahmed AB, Afshari A, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: First update 2016[J]. Eur J Anaesthesiol, 201734(6):332-395.
[6]
De Robertis E, Kozek-Langenecker SA, Tufano R, et al. Coagulopathy induced by acidosis, hypothermia and hypocalcaemia in severe bleeding [J]. Minerva Anestesiol, 201581(1):65-75.
[7]
Muñoz M, Stensballe J, Ducloy-Bouthors AS, et al. Patient blood management in obstetrics: prevention and treatment of postpartum haemorrhage. A NATA consensus statement[J]. Blood Transfus, 201917(2):112-136.
[8]
Mavrides E, Allard S, Chandraharan E, et al. Prevention and Management of Postpartum Haemorrhage: Green-top Guideline No.52[J]. BJOG, 2017124(5):e106-e149.
[9]
Queensland Clinical Guidelines. Postpartum haemorrhage Guideline No.MN18.1-V10-R23 Primary postpartum haemorrhage. Queensland Health. 2021.

URL    
[10]
World Health Organization. WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage, Geneva: WHO,2012.ISBN-13: 978-92-4-154850-2.
[11]
刘兴会,陈锰. 基于大数据的产后出血临床处理[J]. 中国实用妇科与产科杂志201834(1): 33-37.
[12]
Elagamy A, Abdelaziz A, Ellaithy M. The use of cell salvage in women undergoing cesarean hysterectomy for abnormal placentation [J]. Int J Obstet Anesth, 201322(4):289-293.
[13]
Milne ME, Yazer MH, Waters JH. Red blood cell salvage during obstetric hemorrhage[J]. Obstet Gynecol, 2015125(4):919-923.
[14]
Ho KM, Leonard AD. Concentration-dependent effect of hypocalcaemia on mortality of patients with critical bleeding requiring massive transfusion: a cohort study[J]. Anaesth Intensive Care, 201139(1):46-54.
[15]
Collis RE, Collins PW. Haemostatic management of obstetric haemorrhage[J]. Anaesthesia, 201570(Suppl 1):78-86.
[16]
Levi M. Pathogenesis and management of peripartum coagulopathic calamities (disseminated intravascular coagulation and amniotic fluid embolism)[J]. Thromb Res, 2013131(Suppl 1):S32-S34.
[17]
Shields LE, Smalarz K, Reffigee L, et al. Comprehensive maternal hemorrhage protocols improve patient safety and reduce utilization of blood products[J]. Am J Obstet Gynecol, 2011205(4):368.e1-8.
[18]
Treml AB, Gorlin JB, Dutton RP, et al. Massive Transfusion Protocols: A Survey of Academic Medical Centers in the United States [J]. Anesth Analg, 2017124(1):277-281.
[19]
O′brien KL, Shainker SA, Lockhart EL. Transfusion Management of Obstetric Hemorrhage[J]. Transfus Med Rev201832(4):249-255.
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