前置胎盘患者剖宫产术后大出血的影响因素  

Influencing Factors of Massive Bleeding After Cesarean Section in Patients with Placenta Previa

作　　者：李艳伟 LI Yanwei(Department of Obstetrics and Gynecology,Yucheng County People’s Hospital,Shangqiu 476300,China)

机构地区：[1]虞城县人民医院妇产科,河南商丘476300

出　　处：《河南医学研究》2022年第5期869-872,共4页Henan Medical Research

摘　　要：目的分析前置胎盘患者剖宫产术后大出血的发生情况及其影响因素。方法选择2018年1月至2021年12月在虞城县人民医院接受剖宫产手术的115例前置胎盘患者作为研究对象。统计前置胎盘患者剖宫产术后大出血发生率,采用多因素logistic回归分析前置胎盘患者剖宫产术后大出血的影响因素。结果115例前置胎盘患者剖宫产术后共有43例(37.39%)患者发生大出血。单因素分析显示,剖宫产术后大出血的患者与未发生大出血的患者的前置胎盘类型、宫腔操作次数、胎盘附着方向、胎盘植入、瘢痕子宫、术中麻醉方式比较,差异有统计学意义(P<0.05)。多因素logistic回归模型显示,完全性前置胎盘、宫腔操作次数多、前壁胎盘、合并胎盘植入、瘢痕子宫、全身麻醉是前置胎盘患者剖宫产术后大出血的危险因素(OR>1,P<0.05)。结论前置胎盘患者剖宫产术后发生大出血的风险较高,其中完全性前置胎盘、宫腔操作次数多、前壁胎盘、合并胎盘植入、瘢痕子宫、全身麻醉等因素会增加前置胎盘患者剖宫产术后大出血的风险。Objective To analyze the occurrence and influencing factors of massive hemorrhage after cesarean section in patients with placenta previa.Methods A total of 115 patients with placenta previa who underwent cesarean section in Yucheng County People’s Hospital from January 2018 to December 2021 were selected as the research subjects.The incidence of major bleeding after cesarean section in patients with placenta previa was analyzed.Multivariate logistic regression was used to analyze the influencing factors of major bleeding after cesarean section in patients with placenta previa.Results A total of 43(37.39%)of 115 patients with placenta previa had major bleeding after cesarean section.Univariate analysis showed that,there were statistical differences in the type of placenta previa,the number of uterine operations,the direction of placenta attachment,placenta accreta,scar uterus,and intraoperative anesthesia between patients with massive bleeding after cesarean section and those without major bleeding(P<0.05).Multivariate logistic regression model showed that complete placenta previa,frequent uterine cavity manipulations,anterior placenta,combined placenta accreta,scarred uterus,and general anesthesia were the risk factors for post-cesarean hemorrhage in patients with placenta previa(OR>1,P<0.05).Conclusion Patients with placenta previa have a higher risk of major bleeding after cesarean section.Complete placenta previa,frequent uterine operations,anterior placenta,combined placenta accreta,scarred uterus,general anesthesia and other factors will increase the risk of post-cesarean hemorrhage in patients with placenta previa.

关 键 词：前置胎盘 剖宫产术 大出血 影响因素 

分 类 号：R714[医药卫生—妇产科学]