urgent!Women’s sudden bleeding, Qilu Hospital’s multidisciplinary combination and time race

Peninsula All Media Reporter Qi Juan

Recently, Ms. Xin’s vaginal bleeding went to the Qingdao Hospital of Qilu Hospital, Shandong University due to abortion for one month.As well as multi -department medical staff such as ultrasound, and running with time to protect life, she finally worked hard to make Ms. Xin’s danger.

Sudden bleeding from the hospital after women’s abortion surgery

On April 2, 2021, Ms. Xin, who was 13 weeks pregnant, had an abortion surgery in a foreign hospital due to "premature breakthroughs in the fetal membrane and failed to protect the fetus".The second day of the B -ultrasound tip after the operation: See 4.1*2.9*2.8cm block in the upper section of the uterine cavity.This made the attending doctors of the foreign hospital think of the possibility of high -risk placenta implantation and high -risk and rare uterine -mortar venous fistula.

The doctor gave two follow -up treatment methods: First, the uterine arteries involved in the embolism first, and then cleared the palace surgery.This is a relatively safe treatment plan.However, Ms. Xin has a strong desire for fertility. The involvement of uterine arteries may destroy ovarian function, affect the blood transportation of the endometrium, leads to uterine cavity adhesion and reduce fertility;

Second, directly performed the Qing Palace surgery.However, this may occur large bleeding that cannot be controlled. In severe cases, in order to save life, the uterus needs to be removed, and it will not be able to give birth in the later stage.

After communication, at the suggestion of the doctor from a foreign hospital, Ms. Xin chose to apply conservative treatment for the application of drugs, so that the inner block of the uterine cavity gradually shrinks and necrotic, and fall off by herself.Time passed day by day, and more than a month passed. Ms. Xin again reviewed the B -ultrasound. Although the residual "placenta" in the uterus has not changed, her vagina bleeds very little, and her mood gradually becomes relaxed.

Ms. Xin, who thought she was safe, suddenly bleed a lot of vagina at 4 am on May 10, 2021.After dawn, she hurried to the hospital where she was surgery.After arriving at the hospital, the vaginal bleeding decreased significantly. After the doctor gave the citrus treatment, the bleeding almost stopped.Due to the uneasy bleeding and worrying about affecting the subsequent fertility, Ms. Xin and their family members came to the hospital for a gynecological department.

After learning about the situation of Ms. Xin, Deputy Chief Physician Zou Hongli considers that Ms. Xin might be a dynamic venous fistula. It is often a "switch" bleeding, that is, the bleeding is not ahead, but it will suddenly end suddenly, and it is easy to repeat.Although patients are currently bleeding from vaginal bleeding, their vaginal signs are stable, and hemoglobin is normal, for the patient safety, doctors still recommend that patients apply for emergency admission for observation.After communicating with the patient, the doctor asked the doctor to open a vein pathway for the patient while asking the patients to apply for the hospitalization procedures as soon as possible.

Just as the clinic was waiting for admission, the patient had a large number of vaginal bleeding again, the bright red blood spuned out, and instantly stained red pants …

Multi -discipline cooperates with the speed of life and death

After it was discovered that Ms. Xin’s bleeding, the hospital’s gynecology, anesthesiology, and outpatient nurses quickly responded to the scene to rescue the scene. Rescue vehicles, monitoring equipment, and transshipment beds were quickly in place.The medical staff participating in the rescue immediately injected the patient’s shrinkage to the patient to stop the hemostasis of the uterus; at the same time, it opened the second vein pathway to test the blood test and prepare for blood distribution.

Is uterine arterial intervention embolism or hemostasis or directly undergoing Qingyong surgery?The rescuers also contact the operating room and the intervention room to prepare for treatment.But at this time, the patient’s condition was urgent and had to make a choice immediately.After communicating with his family members, his family expressed his trust in the doctor.Doctors on duty reported the patient’s condition, Professor Zhang Peihai, deputy director of the obstetrics and gynecology department and director of gynecology.After understanding the situation in detail, Professor Zhang Peihai organized the rescue work. He said that he immediately went to the operating room to prepare for the abdominal operation.Surgery, ligation bilateral uterine artery or internal iliac artery.

When he arrived at the operating room, various tasks were ready, and Cheng Lei, deputy director of the gynecological department, was prepared for surgery.Before surgery, Ms. Xin began to have irritability, and her blood pressure also dropped to 86/55mmHg (the normal value was 90-139mmHg, and the diastolic blood pressure was 60-89mmHg), which showed a manifestation of blood loss shock.The anesthesiologist Zhang Fangwei emergency cervical vein tube, and the blood transfusion department needs to use urgent blood.

After receiving the application form of an additional blood use, the person in the blood transfusion department was keenly noticed that the patient’s condition was critical, and the hospital’s "emergency blood transfusion plan" was launched according to the process.The staff’s division of labor and cooperation, closely cooperate, detect blood type, cross -blooding, rapid melting plasma, and checking in one go.With everyone’s cooperation, from receiving blood specimens to the first batch of blood taking blood, 18 minutes together.The work style of unity and cooperation of the blood transfusion department has won valuable time for clinical rescue work, and provides a guarantee for the success of the operation.

At this time, the operating room rescue work has not stopped for a while, and the intense and orderly busy work is busy. Anesthesia, ECG monitoring, oxygen absorbing, and urine guidance … When the bright red blood slowly enters Ms. Xin’s body, the passage of life has been opened.Under the guardian, Deputy Chief Physician Cheng Lei quickly cleared the patient’s uterine residue tissue. During the operation, about 20 grams of the residual placenta tissue was sandwiched. The patient’s vaginal bleeding was significantly reduced.Living.

From accident to completing surgery to stop bleeding, in just 50 minutes, Ms. Xin bleed 3000ml in this process (equivalent to 60%of the total blood of 60kg).During the operation, a total of 6.5 units of white blood cells were infused after surgery, and the plasma was 800ml of plasma, and 20 units of cold precipitation were equivalent to half of the whole body blood.

Ms. Xin has a lot of heart. A seemingly ordinary abortion surgery has made her go to the ghost door to turn around.Ms. Xin, who was successfully rescued by the hospital’s multi -disciplinary discipline, recovered well after surgery, but left a shadow in her heart. Each time the room, Professor Zhang Peihai would be held repeatedly, for fear of the attack again.Professor Zhang Peihai comforts each time, explaining the condition and precautions in detail.Professor Zhang’s warm words slowly eased her nervousness and rest assured that they were discharged from the hospital and went home to recuperate.

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