产后即刻主动脉置换产科出血处理

Management of Obstetric Hemorrhage during Immediate Postpartum Aortic Replacement

摘要: 目的：报道1例产后主动脉夹层即刻行主动脉置换手术治疗的病例，警惕产后发生主动脉夹层可能。方法：回顾患者临床资料、多学科协作流程及手术方案，结合文献分析关键处理要点。结果：患者行急诊主动脉置换术，术中通过缩短手术时间、及时逆转肝素化实现有效止血，术后恢复良好。结论：产后急性胸痛伴结缔组织疾病需高度警惕主动脉夹层；急诊手术需平衡抗凝与产后出血风险，优化肝素化管理；多学科协作是救治成功的关键。

Abstract: Objective: To report a case of immediate aortic replacement surgery for postpartum aortic dissection and raise awareness of the possibility of aortic dissection after childbirth. Methods: The clinical data, multidisciplinary collaboration process, and surgical plan of the patient were reviewed, and key management points were analyzed in combination with the literature. Results: The patient underwent emergency aortic replacement surgery. Effective hemostasis was achieved during the operation by shortening the operation time and promptly reversing heparinization. The patient recovered well after the operation. Conclusion: Acute chest pain with connective tissue disease after childbirth should raise high suspicion of aortic dissection. Emergency surgery requires balancing the risk of anticoagulation and postpartum hemorrhage, and optimizing heparin management. Multidisciplinary collaboration is the key to successful treatment.