剖宫产产后出血的原因及高危因素分析  

Causes and Risk Factors of Primary Postpartum Hemorrhage after Cesarean Section

作　　者：曾玉华[1] 谌伦华[1] 王琦[1] 李佳平[1] 

机构地区：[1]川北医学院附属医院妇产科,四川南充637000

出　　处：《川北医学院学报》2010年第6期534-536,共3页Journal of North Sichuan Medical College

摘　　要：目的:分析剖宫产产后出血的原因及高危因素。方法:对我院2005年1月-2010年5月剖宫产产后出血108例进行回顾性分析。结果:剖宫产产后出血发生率5.60%(108/1928),观察组分娩前诊断为病理妊娠88例,占所有剖宫产产后出血病例的81.48%(88/108);对照组诊断病理妊娠19例,占17.60%(19/108);两组比较差异有显著性(χ2=19.53,p<0.01);宫缩乏力是导致产后出血的首位原因(66.67%),其次为胎盘因素(28.70%)。发生产后出血的病例中,在孕期有不同程度的高危因素存在;如妊娠期高血压疾病(包括子痫前期及子痫)、胎盘因素、巨大儿或双胎妊娠、羊水过多及全身因素等。结论:病理妊娠是剖宫产产后出血的高危因素;子宫收缩乏力是剖宫产产后出血的主要原因。Objective：To discuss the causes and risk factors of postpartum hemorrhage after cesarean section.Methods： The authors retrospectively analysed the data from 108 patients with massive bleeding after cesarean section from Jan.2005 to May 2010.Results： The incidence of postpartum hemorrhage during cesarean section was 5.60%;and most of patients（81.48%） had abnormal pregnancies and high risk factors such as hypertensive states of pregnancy（including preeclampsia and eclampsia）,abnormal placentation,fetal macrosomia or multiple pregnancy,etc.The causes of bleeding were uterine atony（66.67%）,placenta factors（28.70%）,uterine incision laceration,and coagulation disorders.Conclusions： Abnormal pregnancy is a risk factor of postpartum hemorrhage during cesarean section,and the main reason is uterine atony.

关 键 词：产后出血 剖宫产 高危因素 

分 类 号：R714.461[医药卫生—妇产科学]