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剖腹产后弥漫性血管内凝血

剖腹产后弥漫性血管内凝血(DIC)是一种严重的并发症,通常与产后大出血相关。根据提供的资料,以下是相关的分析和处理建议:

  1. 病因分析

    • 剖腹产后DIC的发生与产后大出血密切相关。大出血可能由胎盘植入异常、子宫收缩乏力、术中失血过多等因素引起。
    • 资料中提到的病例显示,术中失血量巨大(21,780 ml),并进行了大量输血和输液,这可能导致了凝血功能障碍。
  2. 预防措施

    • 在剖腹产手术中,应密切监测失血量和凝血功能,及时补充血容量和凝血因子。
    • 使用缩宫素等药物促进子宫收缩,减少出血风险。
    • 术后应继续监测患者的生命体征和凝血功能,及时发现和处理异常。
  3. 处理建议

    • 对于已经发生DIC的患者,需进行积极的支持治疗,包括输注新鲜冰冻血浆、血小板和纤维蛋白原,以纠正凝血功能障碍。
    • 必要时进行再手术以控制出血源。
    • 加强术后监护,预防感染和其他并发症。
  4. 临床案例参考

    • 提供的病例分析显示,术后腹腔内出血是一个常见问题,可能需要再手术处理。
    • 术后应警惕腹胀、面色苍白、四肢湿冷等症状,这些可能是内出血的表现。

综上所述,剖腹产后DIC的预防和处理需要多学科协作,及时识别和处理出血及凝血功能障碍是关键。

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