中晚期妊娠孕产妇输血的危险因素分析  

Risk Factors of Perinatal Blood Transfusion

作　　者：王丽 陈锰[2] 张力[2] 高倩[2] 罗方媛[2] 张莉 刘兴会[2] 

机构地区：[1]彭州市妇幼保健院妇产科,成都611930 [2]四川大学华西第二医院妇产科,成都610041

出　　处：《四川大学学报（医学版）》2012年第2期214-217,共4页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技计划项目(2010FZ0078)资助

摘　　要：目的探讨中晚期妊娠孕产妇输血的危险因素。方法对19 456例中晚期妊娠孕产妇的临床资料进行输血相关危险因素的单因素分析和多因素logistic回归分析。结果总输血率为1.49%(289/19 456),将单因素分析中有统计学意义的孕产妇输血的影响因素进行非条件Logistic回归分析,发现孕产妇输血的危险因素有产前红细胞压积(HCT)<25%(OR45.3,95%CI 27.4～74.9)、前置胎盘(OR16.8,95%CI 11.6～24.3)、产前HCT 25%～30%(OR11.4,95%CI6.7～19.7)、少数民族(OR4.8,95%CI1.6～14.0)、胎盘早剥(OR4.5,95%CI1.7～11.5)、多胎妊娠(OR2.8,95%CI1.6～4.9)、子痫前期(OR2.6,95%CI1.5～4.4),P均<0.01。结论虽然孕产妇总的输血率不高,但是以上因素尤其是产前严重贫血(HCT<25%)和前置胎盘明显增加了输血的危险性,临床医生应重视相关的产前筛查和围产保健。Objective To investigate the risk factors associated with perinatal packed red blood cell transfusion.Methods We performed univariable analysis and unconditional multivarible logistic regression analysis to identify risk factors associated with perinatal packed red blood cell transfusion in 19 456 obstetrical inpatients.Results The transfusion rate was 1.49%（289/19,456）.Prenatal hematocrit（HCT） less than 25%（OR 45.3,95%CI 27.4-74.9）,placenta previa（OR 16.8,95%CI 11.6-24.3）,prenatal HCT 25%-30%（OR 11.4,95%CI 6.7-19.7）,ethnic minority（OR 4.8,95%CI 1.6-14.0）,placenta abruption（OR 4.5,95%CI 1.7-11.5）,multiple gestation（OR 2.8,95%CI 1.6-4.9） and preeclampsia（OR 2.6,95%CI 1.5-4.4） were risk factors associated with perinatal packed red blood cell transfusion.Conclusion Although the overall perinatal transfusion rate is low,severe prenatal anemia（HCT 25%） and placenta previa can increase the risk of transfusion markedly.It is crucial for obstetricians to provide appropriate perinatal care for those patients.

关 键 词：孕产妇 输血 危险因素 LOGISTIC回归分析 

分 类 号：R457.1[医药卫生—治疗学] R714.2[医药卫生—临床医学]