产后出血的早期识别及相关因素的临床研究  

The early identification and analysis of related factors of postpartum hemorrhage

作　　者：张丽[1] 杨鲜[1] 

机构地区：[1]北京市昌平区中西医结合医院妇产科,102208

出　　处：《检验医学与临床》2016年第4期487-489,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨产后出血的相关危险因素,为产后出血的早期识别与预防措施提供依据。方法随机抽取2012年1月至2014年12月该院产科分娩的3 200例产妇,回顾性分析其临床资料,应用容积法与称质量法记录产后出血量,分析产后出血危险因素,并作单因素与多元Logistic回归分析,总结导致产后出血的独立危险因素。结果单因素分析结果表明:产次超过2次、多胎妊娠、胎次超过2次、合并妊娠高血压综合征、前置胎盘、子宫收缩乏力、巨大儿、剖宫产、胎盘粘连、胎盘早剥、早产均为导致产后出血的相关危险因素;多因素回归分析结果显示:子宫收缩乏力、前置胎盘、胎盘粘连、巨大儿、剖宫产为产妇产后出血的独立危险因素。结论针对导致产妇产后出血的独立危险因素,强化对宫缩乏力的预防,加强孕期宣教,做好计划生育,严格掌握剖宫产指征,对降低产妇产后出血发生率具有临床意义。Objective To investigate the risk factors of postpartum hemorrhage and provide references for early identification and the formulation of prevention measures of postpartum hemorrhage.Methods 3 200 cases of pregnant women were randomly selected as the research object that delivering in the hospital during the period of January 2012 to December 2014,whose clinical datum were retrospectively analyzed.The volume of postpartum hemorrhage was recorded with the application of the volumetric method and weighing method.The risk factors of postpartum hemorrhage were analyzed by the single factor and multiple logistic regression analysis.The independent risk factors which caused postpartum hemorrhage were summarized to provide the basis for early identification of postpartum hemorrhage.Results The results of single factor analysis showed that more than 2times of production,multiple pregnancy,more than 2times of parity,combined pregnancy hypertension,placenta previa,uterine inertia,fetal macrosomia,cesarean section,adherent placenta,placental abruption and premature delivery were the risk factors of postpartum hemorrhage.The results of multiple regression analysis confirmed that uterine inertia,placenta previa,adherent placenta,fetal macrosomia and cesarean section were the independent risk factors of postpartum hemorrhage.Conclusion Uterine inertia,placenta previa,adherent placenta,fetal macrosomia and cesarean section were the independent risk factors of postpartum hemorrhage.To strengthen the prevention of uterine inertia and the education of pregnancy,family planning of good implement and strict cesarean section indications played a positive role in reducing the incidence of postpartum hemorrhage.

关 键 词：产后出血 识别 危险因素 预防 

分 类 号：R714.3[医药卫生—妇产科学]