624例剖宫产术后出血及相关因素分析  

Blood loss in 624 cases after cesarean section

作　　者：朱宁[1] 樊平[1] 窦娜[1] 熊利华[1] 卢彦平[1] 

机构地区：[1]解放军总医院妇产科,北京100853

出　　处：《军医进修学院学报》2011年第5期473-474,共2页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的研究剖宫产术后24h阴道出血情况,提高剖宫产术后医疗护理质量。方法对624例剖宫产病例进行前瞻性研究,剖宫产手术结束后立即开始收集阴道血至产后24h,称重法测量出血量。手术前及手术后1-2d测血常规,出血多病例随时进行相关检查及处理。结果术中出血量平均(265.14±160.42)ml,手术结束后至24h出血量(152.51±160.42)ml,24h总出血量(416.98±208.76)ml。以剖宫产术中出血≥400ml为产后出血诊断标准,产后出血率为6.89%;以产后24h出血量≥500ml为标准,产后出血率达14.90%,差异有统计学意义(P<0.05)。剖宫产术后至24h有76.76%患者出血量≥100ml。子宫乏力为产后出血的首要原因。结论加强剖宫产术后病人管理,及时发现并减少产后出血发生。Objective To study how to improve the nursing for women after cesarean section by measuring the blood loss during the first 24 hours after cesarean section.Methods Postpartum blood loss of 624 women was immediately measured with the weighing method 24 hours after cesarean section.Blood routine examination was performed 1-2 days before and cesarean section.Women with more blood loss underwent corresponding examinations and treatment.Results The average blood loss was 265.14±160.42ml during operation and 152.51±160.42ml during first 24h after operation.The total blood loss was 416.98±208.76ml during the first 24 hours after operation.When the blood loss≥400ml after cesarean section was used as the diagnostic criteria of postpartum hemorrhage,the blood loss rate was 6.89% and when the blood loss≥500ml after cesarean section was used as the diagnostic criteria of postpartum hemorrhage,the blood loss rate was 14.90%（P0.05）.The blood loss was≥100ml in 76.76%（479/624） women during the first 24h after cesarean section.Uterine inertia was found to be the primary factor for postpartum hemorrhage.Conclusion Management of women after cesarean section should be strengthened in order to reduce their postpartum hemorrhage.

关 键 词：剖宫产 产后出血 子宫收缩乏力 

分 类 号：R714[医药卫生—妇产科学]