Marrón Peña M
Hospital de Gineco-Obstetricia No. 4 Dr. Luis Castelazo Ayala IMMS, México, D.F.
Ginecol Obstet Mex. 1995 Jun;63:237-42.
Severe genital hemorrhage is one of the three leading causes of death in gyneco-obstetrics and oncology. Since this problem is a surgical emergency leaving no room for delay, the causes for this phenomenon are analysed in this paper, stressing the importance of detection and clinical assessment in order to determine the effective and immediate type of corrective surgical procedure. The principal objective is to specify the role of the anesthesiologist during the patient's preoperative, transoperative and postoperative periods. Some general and some specific recommendations are made with regards to the selection of the anesthetic technique depending on the degree of hemorrhage and the type of operation later to be performed. Finally, the criteria for two types of therapy are presented: blood transfusion therapy (and the transfusion of blood components) and hydroelectrolytic therapy, in which the anesthesiologist and the internist perform an essential role in the intensive care units, the latter being the ideal site for postoperative management.
严重生殖器出血是妇产科和肿瘤学领域三大主要死因之一。由于该问题属于外科急症，刻不容缓，本文对这一现象的成因进行了分析，强调了检测和临床评估对于确定有效且即时的矫正性手术类型的重要性。主要目的是明确麻醉医生在患者术前、术中及术后阶段的作用。针对根据出血程度和后续要实施的手术类型选择麻醉技术给出了一些一般性和特定性建议。最后，介绍了两种治疗标准：输血治疗（及血液成分输血）和水电解质治疗，其中麻醉医生和内科医生在重症监护病房发挥着至关重要的作用，重症监护病房是术后管理的理想场所。
