前置胎盘产妇剖宫产术后大出血发生情况及其影响因素分析  

Analysis on the Occurrence of Massive Hemorrhage after Cesarean Section in Puerperas with Placenta Previa and the Influencing Factors

作　　者：张镛镛[1] 雷利娜[1] 薛秀珍[1] ZHANG Yongyong;LEI Li'na;XUE Xiuzhen(Department of Obstetrics,the First Affiliated Hospital of He'nan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院产科,河南洛阳471000

出　　处：《临床医学工程》2021年第1期119-120,共2页Clinical Medicine & Engineering

基　　金：2015年河南省医学科技攻关计划项目“凶险性前置胎盘的临床处理流程探讨”(项目编号:201504026)。

摘　　要：目的探讨前置胎盘产妇剖宫产术后大出血的发生情况,并分析其相关影响因素。方法回顾性分析2016年10月至2018年3月于我院行剖宫产的120例前置胎盘产妇的临床资料,统计其剖宫产术后大出血发生率,并经单因素与多因素分析影响前置胎盘产妇剖宫产术后大出血的危险因素。结果120例前置胎盘产妇中,22例发生剖宫产术后大出血,发生率为18.33%。经单因素分析显示,前置胎盘产妇发生剖宫产术后大出血不受孕前BMI、流产次数影响(P〉0.05),但可能受胎盘粘连、合并胎盘植入、产妇年龄、前置胎盘分型的影响(P<0.05)。Logistic回归分析显示,胎盘粘连、合并胎盘植入、产妇高龄、完全性前置胎盘是引发前置胎盘产妇剖宫产术后大出血的危险因素(0R>1,P<0.05)。结论胎盘粘连、合并胎盘植入、产妇高龄、完全性前置胎盘可增加前置胎盘产妇剖宫产术后大出血的发生风险,临床需予以密切关注,采取科学合理的干预措施。Objective To explore the occurrence of massive hemorrhage after cesarean section in puerperas with placenta previa,and to analyze the related influencing factors.Methods The clinical data of 120 puerperas with placenta previa with cesarean section in our hospital from October 2016 to March 2018 were retrospectively analyzed.The incidence of massive hemorrhage after cesarean section was counted,and the risk factors of massive hemorrhage after cesarean section in puerperas with placenta previa were analyzed by univariate and multivariate analysis.Results Among 120 puerperas with placenta previa,22 cases had massive hemorrhage after cesarean section,accounting for 18.33%.Univariate analysis showed that massive hemorrhage after cesarean section in puerperas with placenta previa was not affected by pre-pregnancy BMI and abortion times(P>0.05),but might be affected by placenta adhesion,placenta accreta,maternal age and placenta previa type(P<0.05).Logistic regression analysis showed that placental adhesion,placenta accreta,advanced maternal age and complete placenta previa were the risk factors of massive hemorrhage after cesarean section(0R>1,P<0.05).Conclusions Placental adhesion,placenta accreta,advanced maternal age and complete placenta previa can increase the risk of massive hemorrhage after cesarean section in puerperas with placenta previa.It is necessary to pay close attention to the above high-risk factors in clinic and take scientific and reasonable intervention measures.

关 键 词：前置胎盘 剖宫产 大出血 影响因素 

分 类 号：R719.8[医药卫生—妇产科学]