血浆纤维蛋白原、血小板计数及D-二聚体检验对预测产后出血的价值  

The Value of Plasma Fibrinogen,Platelet Count and D-Dimer Test in Predicting Postpartum Hemorrhage

作　　者：庄远丽 ZHUANG Yuanli(Department of Obstetrics and Gynecology,Dehua County Hospital,Dehua,Fujian 362500,China)

机构地区：[1]德化县医院妇产科,福建德化362500

出　　处：《中国医药指南》2025年第12期32-35,共4页Guide of China Medicine

基　　金：泉州市科技计划项目(2016Z005)。

摘　　要：目的 分析血浆纤维蛋白原(FIB)、血小板计数(PLT)及D-二聚体(D-D)检验对预测产后出血的价值。方法 选取本院在2022年8月至2024年8月收治的70例产妇进行研究,根据其产后是否出现出血分为未出血组(n=42),出血组(n=28),给予FIB、PLT及D-D检验,分析其一般资料,对其相关数据进行Pearson分析。结果 出血组年龄(≥35岁)、产次(≥2次)、分娩方式(剖宫产)、妊娠并发症(有)、分娩孕周(<37周)、前置胎盘(有)、胎儿体重(≥4 000 g)、胎盘粘连(有)、胎盘早剥(有)均高于未出血组(P<0.05);两组产妇体重(≥23 kg/m^(2)、<23 kg/m^(2))、受孕方法(自然受孕、辅助生殖技术)对比,差异无统计学意义(P> 0.05);出血组FIB、PLT水平均低于未出血组(P<0.05);D-D水平高于未出血组(P<0.05);Pearson结果分析:FIB、PLT及D-D的AUC分别为0.882、0.884、0.834;联合检验在预测产后出血中的AUC为0.969;联合检验的AUC均高于单独检验的FIB、PLT及D-D水平(P<0.05);Logistic结果分析:以年龄、产次、分娩方式、妊娠并发症、分娩孕周、前置胎盘、胎儿体重、胎盘粘连、胎盘早剥、FIB、PLT、D-D为自变量,以产后出血为因变量;其中分娩方式、妊娠并发症、前置胎盘、胎儿体重、胎盘粘连、胎盘早剥、FIB、PLT均是造成产后出血的危险因素(P<0.05);D-D为保护因素(P<0.05)。结论 FIB、PLT及D-D在产后出血的预测中具有重要价值,且联合检测能显著提高预测准确性。Objective The value of plasma fibrinogen(FIB),platelet count(PLT)and D-dimer(D-D)test in predicting postpartum hemorrhage was analyzed.Methods A total of 70 parturients admitted to our hospital from August 2022 to August 2024 were selected for this study.According to whether postpartum hemorrhage occurred,they were divided into non-bleeding group(n=42)and bleeding group(n=28).FIB,PLT and D-D tests were given to analyze their general data,and Pearson analysis was performed on their related data.Results Age(≥35 years),delivery times(≥2 times),delivery mode(cesarean section),pregnancy complications(yes),gestational week(<37 weeks),placenta previa(yes),fetal body weight(≥4000 g),placental adhesion(yes)and placental abruption(yes)in hemorrhage group were higher than those in non-hemorrhage group(P<0.05).There was no significant difference in body weight(≥23 kg/m^(2),<23 kg/m^(2))and conception method(natural conception,assisted reproductive technology)between the two groups(P>0.05).The levels of FIB and PLT in bleeding group were lower than those in non-bleeding group(P<0.05).The level of D-D was higher than that of non-bleeding group(P<0.05).The AUC of FIB,PLT and D-D were 0.882,0.884 and 0.834,respectively.The AUC of combined test in predicting postpartum hemorrhage was 0.969.The levels of FIB,PLT and D-D of combined test were higher than those of single test(P<0.05).Logistic analysis of results:Age,delivery time,delivery mode,pregnancy complications,gestational weeks,placenta previa,fetal body mass,placental adhesion,placental abruption,FIB,PLT,D-D were independent variables,and postpartum hemorrhage was dependent variables.Delivery mode,pregnancy complications,placenta previa,fetal body mass,placental adhesion,placental abruption,FIB and PLT were all risk factors for postpartum hemorrhage(P<0.05).D-D was the protective factor(P<0.05).Conclusions FIB,PLT and D-D have important value in the prediction of postpartum hemorrhage,and the combined detection can significantly improve the prediction accuracy.

关 键 词：血浆纤维蛋白原 血小板计数 D-二聚体 预测 产后出血 

分 类 号：R714.461[医药卫生—妇产科学]