妇科术后发生盆腔血肿的临床分析  

Clinical analysis of gynecological postoperative pelvic hematoma

作　　者：江红[1] 黄艳丽[1] 覃小敏[1] 王冉冉[1] 兰艳丽[1] 

机构地区：[1]湖北省襄阳市中心医院妇产科,441021

出　　处：《中国妇产科临床杂志》2016年第5期416-418,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨妇科手术后并发盆腔血肿的危险因素及其治疗方法。方法采用病例对照研究的方法,在湖北省襄阳市中心医院就诊的42例妇科手术后并发盆腔血肿妇女作为病例组,按照1∶2原则选取妇科术后未发生盆腔血肿妇女84例作为对照组,采用单因素、多因素的非条件logistics回归方法分析发生盆腔血肿的危险因素。结果 42例诊断盆腔血肿患者后均采用静脉滴注头孢二代加甲硝唑及口服败酱汤治疗,住院天数20~31 d,平均住院时间（25.44±4.56）d,42例盆腔血肿患者均未进行二次手术,均痊愈出院。多因素分析：年龄≥45岁（OR=1.276）、合并心肺部疾患率（OR=1.775）、术前应用抗凝药物（OR=1.692）、术中出血量较多（OR=1.302）、纤维蛋白原值降低（OR=1.276）是妇科手术患者术后并发盆腔血肿的独立危险因素。结论年龄、合并心肺疾患、纤维蛋白原降低及术前使用抗凝药物是妇科手术患者术后并发盆腔血肿的独立危险因素,妇科术后盆腔血肿患者的治疗以抗炎、活血化瘀为主。Objective To study the risk factors of pelvic hematoma after gynecological surgery and its treatment. Methods This is a case-control study. 42 patients of pelvic hematoma post gynecological surgury treated in our department recuruitd as study group, 84 post gynecological operation patients without pelvic hematoma recruited as control group, using the single factor and multiple factors unconditioned logistics regression method to analyze the risk factors of pelvic hematoma,. Results 42 patients of pelvic hematoma were recovered after treated with second generation of metronidazole and oral cephalosporin with miso soup treatment and no secondary surgery needed. The hospitalized days was 20 ~ 31 days with the average length of（25.44±4.56）d. Multiple factors analysis showed that age greater than 45 years（OR=1.276）,combined cardiac and pulmonary disease（OR=1.775）, preoperative use of anticoagulant drugs（OR=1.692）,the amount of bleeding during operation（OR=1.302）, reduce of fibrinogen（OR=1.276） were independent risk factors associated with pelvic hematoma. Conclusions Age, heart and lung disease and preoperative use of anticoagulant drugs are independent risk factors for postoperative pelvic hematoma in patients with gynecological. Anti-inflammatory and promoting blood circulation is effective treatment for these patients.

关 键 词：妇科手术 盆腔血肿 危险因素 治疗方法 

分 类 号：R713[医药卫生—妇产科学]