影响胎盘早剥患者剖宫产产后出血的危险因素分析及相应预防对策研究  

Risk Factors and Preventive Measures of Postpartum Hemorrhage during Cesarean Section in Patients with Placental Abruption

作　　者：孙磊[1] 米立芬 夏亚静 张培芳 孔翠花[1] 赵力力[2] Sun Lei;Mi Lifen;XiaYajing;Zhang Peifang;Kong Cuihua;Zhao Lili(The Delivery Room of the Second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,Hebei Province,China;不详)

机构地区：[1]邢台医学高等专科学校第二附属医院产房,河北省邢台市054000 [2]邢台医学高等专科学校第二附属医院儿科,河北省邢台市054000

出　　处：《中国病案》2021年第12期60-63,共4页Chinese Medical Record

摘　　要：目的探讨影响胎盘早剥患者剖宫产产后出血的危险因素及相应预防对策。方法选取2017年10月1日-2020年6月30日某院收治的胎盘早剥行剖宫产患者175例,将伴有产后出血的62例作为出血组,未合并产后出血者113例作为常规组,比较2组凝血功能指标,对出血组和常规组临床资料进行单因素分析,并对影响胎盘早剥患者剖宫产产后出血的危险因素进行Logistic回归分析。结果出血组PLT、APTT、PT等指标明显低于常规组,差异有统计学意义,t=27.424、22.812、12.717,P=0.000。经过χ^(2)检验,子痫前期、早产、绒毛膜羊膜炎、宫缩乏力、胎盘后壁、发病持续时间≥3小时为胎盘早剥患者剖宫产产后出血的影响因素,差异有统计学意义,P<0.05。经Logistic回归分析,子痫前期、早产、绒毛膜羊膜炎、宫缩乏力、胎盘后壁、发病持续时间≥3小时为可能导致胎盘早剥患者剖宫产产后出血的独立危险因素,差异有统计学意义,P<0.05。结论胎盘早剥容易增加剖宫产产后出血发生风险,且与子痫前期、早产、绒毛膜羊膜炎、宫缩乏力、胎盘后壁、发病持续时间等因素存在相关,应针对患者个体情况制定相应预防措施,降低产后出血风险,改善母婴预后。Objective Combined with clinical practice experience,this paper discusses the risk factors of postpartum hemorrhage in patients with placental abruption during cesarean section and the corresponding preventive measures.Methods A total of 175 patients with placental abruption undergoing cesarean section admitted to our hospital from October 1,2017 to June 31,2020 were selected,62 cases of postpartum hemorrhage patients as hemorrhage group,unincorporated,113 cases of postpartum hemorrhage patients as normal group,compared two groups of patients blood coagulation function index,the hemorrhage group and routine clinical data are single factor analysis,and the influence of placental abruption cesarean section of postpartum hemorrhage in patients with risk factors for Logistic regression analysis.Results PLT,APTT,PT and other indexes in the bleeding group were significantly lower than those in the routine group,and the difference was statistically significant(t=27.424,22.812,12.717,P=0.000).Through χ^(2) test,preeclampsia,preterm labor,chorioamnitis,uterine weakness,posterior wall of placenta,onset duration ≥3 h were the influencing factors for postpartum hemorrhage during cesarean section in patients with placental abruption,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that preeclampsia,premature labor,chorioamnitis,uterine weakness,posterior wall of placenta and onset duration ≥3 h were independent risk factors for postpartum hemorrhage during cesarean section in patients with placental abruption,and the difference was statistically significant(P<0.05).Conclusion Placental abruption is easy to increase the risk of cesarean delivery postpartum hemorrhage occurred with preeclampsia,premature birth and chorioamnionitis,weakness of contractions,placenta after wall,duration of disease and other related factors,should be set for individual patients under you supply prevention measures,reduce the risk of postpartum hemorrhage,improve maternal and infant prognosis,is worth

关 键 词：胎盘早剥 剖宫产 产后出血 危险因素 预防对策 

分 类 号：R714.461[医药卫生—妇产科学]