剖宫产术后早期产后出血相关因素分析及防治对策  

Early clinical analysis of related factors and cuontermeasures of postpartum hemorrhage after cesarean section

作　　者：张丹[1] 吴晓鹃[1] 

机构地区：[1]抚顺矿务局总医院妇产科,辽宁抚顺113008

出　　处：《中国现代医生》2016年第2期52-54,57,共4页China Modern Doctor

摘　　要：目的探讨剖宫产术后早期产后出血相关因素分析及防治对策。方法收集314例剖宫产产妇临床资料进行回顾性研究,其中81例（25.80%）发生产后出血（剖宫产组）,同期选取198例自然分娩产妇为对照组,分析影响剖宫产术后早期产后出血的相关因素。结果剖宫产组出血比例为25.80%,明显高于对照组的5.56%,剖宫产组平均出血量多于对照组,住院时间短于对照组,差异均具有统计学意义（P〈0.05）,剖宫产组中67例（82.72%）出血量介于500~1000 m L,11例（13.58%）出血量介于1000～2000 m L,3例（3.70%）出血量超过2000 m L,差异具有统计学意义（P〈0.05）;单因素分析：宫缩乏力、胎盘因素、子宫裂伤、多次妊娠、妊娠高血压、多胎等组间差异具有统计学意义（P〈0.05）,经过Logistic回归分析,宫缩乏力、胎盘因素、子宫裂伤、妊娠高血压、多胎等因素为剖宫产早期产后出血独立危险因素（P〈0.05）。结论剖宫产术后早期出血可能性高于自然分娩者,并且可能危险因素为宫缩乏力、胎盘因素、子宫裂伤、妊娠高血压、多胎,临床应该根据危险因素采取合适预防出血措施和止血方法。Objective To explore related factors and cuontermeasures of postpartum hemorrhage after cesarean section.Methods A total of 314 cases with cesarean section maternal were retrospectively studied, of which 81 cases（25.8%）occurred postpartum hemorrhage, and chose 198 cases of natural childbirth as control group, the impact of early postpartum hemorrhage after cesarean section relevant factors were analyzd. Results The bleeding proportion of cesarean section group was 25.80%, significantly higher than 5.56% in the control group, the average amount of bleeding of caesarean section group was more than that in the control group, hospital stay was shorter than that in the control group,the differences were statistically significant（P〈0.05）, wherein the cesarean section group 67 patients（82.72%） bleeding between 500 and 1000 m L, 11 cases（13.58%） bleeding between 1000 and 2000 m L, 3 patients（3.70%） bleeding than2000 m L, had statistically significant difference（P0.05）; Univariate analysis： the difference was statistically significant（P〈0.05） between uterine inertia, placenta, uterine laceration, multiple pregnancy, pregnancy-induced hypertension,multiple births; Through Logistic regression analysis, palace reduced fatigue, placenta, uterine laceration, pregnancy-induced hypertension, multiple births and other factors cesarean section early postpartum hemorrhage were independent risk factors（P〈0.05）. Conclusion Early postoperative bleeding caesarean section is higher than the possibility of spontaneous labor, and possible risk factors uterine inertia, placenta, uterine laceration, pregnancy-induced hypertension,multiple births, clinical should take appropriate measures to prevent bleeding and bleeding risk factors method.

关 键 词：剖宫产术 早期产后出血 因素分析 防治对策 

分 类 号：R719.8[医药卫生—妇产科学]