产后阴道壁血肿发生原因及预防、护理措施探讨  

Discussion on Causes,Prevention and Nursing Measures of Postpartum Vaginal Wall Hematoma

作　　者：徐蒙赐 Xu Mengci(Hubei Huangshi Industrial and Mining Hospital,Huangshi 435000,Hubei Province,China)

机构地区：[1]湖北省黄石工矿医院,湖北黄石435000

出　　处：《中国社区医师》2023年第14期127-129,132,共4页Chinese Community Doctors

摘　　要：目的:分析产后阴道壁血肿发生的原因,探讨预防及护理措施。方法:选取2018年1月—2021年1月湖北省黄石工矿医院收治的45例产后阴道壁血肿患者作为观察组,选取同期45例产后未发生阴道壁血肿的产妇作为对照组。收集产妇临床资料,分析影响产妇阴道壁血肿的危险因素。结果:单因素分析结果显示,合并肝炎、凝血因子含量下降、合并妊娠期高血压综合征、巨大儿、产道瘢痕、产道囊肿、阴道壁伸展性差、合并细菌感染、合并病毒感染、产程过快、宫内压高、10 min内子宫收缩次数多、产程延长、会阴侧切切口角度不适、会阴保护不当、助产手术欠缺为影响产妇产后阴道壁血肿的危险因素,差异有统计学意义(P<0.05)。多因素分析结果显示,凝血因子含量下降、妊娠期高血压综合征、巨大儿、产道瘢痕、细菌感染、病毒感染、产程延长、会阴侧切切口角度不适、助产手术欠缺为产妇产后阴道壁血肿的独立危险因素,差异有统计学意义(P<0.05)。结论:影响产妇产后阴道壁血肿的危险因素较多,临床应针对产妇的具体情况实施针对性预防及护理措施,以降低产后阴道壁血肿发生率,改善产妇预后。Objective:To analyze the causes of postpartum vaginal wall hematoma and discuss the preventive and nursing measures.Methods:From January 2018 to January 2021,45 patients with postpartum vaginal wall hematoma at the Hubei Huangshi Industrial and Mining Hospital were selected as the observation group,and 45 patients with no postpartum vaginal wall hematoma during the same period were selected as the control group.The clinical data of parturient women were collected to analyze the risk factors of parturient vaginal wall hematoma.Results:The results of single-factor analysis revealed that concurrent hepatitis,decreased coagulation factor content,concurrent pregnancy-induced hypertension syndrome,macrosomia,birth canal scar,birth canal cyst,poor vaginal wall extension,concurrent bacterial infection,concurrent viral infection,rapid labor,high intrauterine pressure,frequent uterine contractions within 10 min,prolonged labor,discomfort in the lateral incision angle of the perineum,improper perineal protection and lack of midwifery were the risk factors for postpartum vaginal wall hematoma,with statistically significant difference(P<0.05).The results of multi-factor analysis revealed that the decreased coagulation factor content,pregnancy-induced hypertension syndrome,macrosomia,birth canal scar,bacterial infection,viral infection,prolonged labor,discomfort in the lateral incision angle of the perineum and lack of midwifery were the independent risk factors for postpartum vaginal wall hematoma,with statistically significant difference(P<0.05).Conclusion:There are numerous risk factors affecting postpartum vaginal wall hematoma.Clinical targeted prevention and nursing measures should be implemented according to the specific conditions of parturient women to reduce the incidence of postpartum vaginal wall hematoma and improve parturient outcome.

关 键 词：产后阴道壁血肿 产妇 影响因素 

分 类 号：R473.71[医药卫生—护理学]