严重原发性产后出血的影响因素分析  

Analysis of influencing factors of severe postpartum hemorrhage

作　　者：谢薇[1] 王妍 陈秋燕 黄建玲[1] XIE Wei;WANG Yan;CHEN Qiuyan;HUANG Jianling(Department of Obstetrics,Jiujiang Maternal and Child Health Hospital,Jiangxi Province,Jiujiang332000,China)

机构地区：[1]江西省九江市妇幼保健院产科,江西九江332000

出　　处：《中国当代医药》2024年第4期99-102,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202140369)。

摘　　要：目的探讨导致分娩产妇严重原发性产后出血(PPH)的独立危险因素。方法回顾性选取2016年12月至2021年12月九江市妇幼保健院收治的536例合并PPH的分娩产妇作为研究对象,根据分娩产妇PPH严重程度分为非严重PPH组(n=125)和严重PPH组(n=411)。采用单因素分析和logistic多因素回归分析探讨分娩产妇严重PPH的危险因素。结果非严重PPH组和严重PPH组分别占所有分娩产妇的2.1%和0.49%。单因素分析结果显示,两组产妇的年龄、孕前体重指数(BMI)、分娩次数、剖宫产史、羊水过多、出生体重、多胎妊娠、严重子痫前期、绒毛膜羊膜炎、产程延长、分娩方式和全身麻醉情况比较,差异均有统计学意义(P<0.05)。多因素分析结果显示,剖宫产史(β=0.884,OR=3.15,95%CI=1.02~10.30)、产程延长(β=1.821,OR=3.62,95%CI=3.21~4.03)和紧急剖宫产(β=0.835,OR=4.75,95%CI=1.32~12.96)是严重PPH的独立危险因素(P<0.05)。结论具有剖宫产史、产程延长及接受紧急剖宫产的产妇需引起重视,避免不必要的剖宫产、长时间分娩及紧急剖宫产发生率,减少严重PPH的发生。Objective To investigate the independent risk factors of severe postpartum hemorrhage(PPH)in parturient women.Methods A total of 536 paraparients with PPH admitted to Jiujiang Maternal and Child Health Hospital from December 2016 to December 2021 were retrospectively selected as the research objects,and they were divided into non-severe PPH group(n=125)and severe PPH group(n=411)according to the severity of PPH.Univariate analysis and logistic regression analysis were used to investigate the risk factors of severe PPH in parturients.Results The non-severe PPH group and the severe PPH group accounted for 2.1%and 0.49%of all women giving birth,respectively.Unifactor analysis showed that there were statistically significant differences in age,pre-pregnancy body mass index(BMI),delivery times,cesarean section history,excessive amniotic fluid,birth weight,multiple pregnancy,severe preeclampsia,chorioamniitis,prolonged labor,delivery mode and general anesthesia between the two groups(P<0.05).The results of multivariate analysis showed that history of cesarean section(β=0.884,OR=3.15,95%CI=1.02-10.30),prolonged labor(β=1.821,OR=3.62,95%CI=3.21-4.03)and emergency cesarean section(β=0.835,OR=4.75,95%CI=1.32-12.96)were independent risk factors for severe PPH(P<0.05).Conclusion Women who have history of cesarean section,prolonged labor and emergency cesarean section need to pay attention to avoid unnecessary cesarean section,long delivery and emergency cesarean section incidence,and reduce the occurrence of severe PPH.

关 键 词：紧急剖宫产 围生期结局 原发性产后出血 产程延长 

分 类 号：R714.4[医药卫生—妇产科学]