基层医院产后出血相关因素的临床研究  

Clinical Research on Relevant Factors of Postpartum Hemorrhage in Local Hospitals

作　　者：钭妙莺 周素文 邓火生 朱玉珍 吴凤萍 

机构地区：[1]江西省资溪县人民医院,江西资溪335300 [2]江西省抚州市第一医院,江西抚州344000 [3]江西省抚州市中医学校,江西抚州344000

出　　处：《临床医学工程》2009年第4期33-35,共3页Clinical Medicine & Engineering

基　　金：2006年度江西省抚州市科技计划项目(编号15)。

摘　　要：目的分析研究基层医院产妇产后出血的相关因素,提出合理的防治措施,以降低产后出血的发生率,降低孕产妇死亡率。方法以2003年4月～2006年1月在我院阴道分娩产后出血的足月产妇和在家或乡卫生院分娩后阴道大出血由120接诊入院的足月产妇58例和总分娩数2108例作为观察对象。通过非条件logistic回归分析筛选出与产后出血相关的主要危险因素,利用SAS8.1进行统计学分析,P<0.05为差异有显著性。结果在2108例阴道分娩的足月产妇中,产后出血58例,占分娩总数的2.75%。其中子宫收缩乏力34例,占58.6%;胎盘因素14例,占24.1%;软产道损伤9例,占15.1%;凝血功能障碍1例,占1.7%。35岁及以上组的产后出血发生率明显高于20岁～34岁组的产后出血发生率,经产妇组的产后出血发生率显著高于初产妇组产后出血的发生率。结论产后出血以子宫收缩乏力占首位,其次为胎盘因素、软产道损伤、凝血功能障碍、子宫内翻。只有把农村和基层医院的产后出血控制到较低水平,才能使孕产妇的死亡率持续下降。因此,重视农村和基层医院的发展极其重要。Objective To analyze the relevant factors of maternal postpartum hemorrhage in local hospitals, taking reasonable preventive measures for reduction of the incidence of postpartum hemorrhage and reduction of the maternal mortality. Methods 2108 cases of delivery women, of whom 58 cases with postpartum vaginal hemorrhage from April 2003 to January 2006 in our hospital or local hospitals, were observed. By non-conditional logistic regression analysis associated with postpartum hemorrhage, the main risk factors were selected; by SAS 8.1 for statistical analysis, there was significant difference （P 〈0.05）. Results 2108 cases of vaginal delivery at full-term births, 58 cases were of postpartum hemorrhage（2.75%）, of which there were 34 cases of uterine atony（58.6%）, 14 cases of placental factors（24.1%）, 9 cases of soft birth canal injury（15.1%）, and one cases of coagulation disorder（1.7%）. The incidence of postpartum hemorrhage above 35-year-old group was significantly higher than that in 20-year-old to 34-year-old group; the incidence of postpartum hemorrhage in maternal group was significantly higher than that in primipara group. Conclusion The relevant factors of postpartum hemorrhage lies in uterine atony, followed by placental factors, injury of soft birth canal, coagulation disorde and uterine inversion. Only in control of postpartum hemorrhage to a lower level in local hospitals, can matemal mortality continue to decline. Therefore, the development of local hospitals is of vital importance.

关 键 词：基层医院 产后出血 相关因素 临床研究 处理措施 预防保健 

分 类 号：R714.461[医药卫生—妇产科学]