剖宫产重度产后出血的临床分析(附65例报告)

Qinical Analysis of Severe Postpartum Hemorrhage about Cesarean Section:a 65 Cases Report

目的:探讨剖宫产重度产后出血的相关因素及防治措施。方法:对1997年1月～2005年6月剖宫产分娩的65例重度产后出血临床资料进行回顾性分析。结果:剖宫产重度产后出血的发生率为0．25％,其中87．6％发生在产后2 h;阴道分娩重度产后出血的发生率为0．14％。剖宫产重度产后出血的发生率与阴道分娩相比,有显著差异(P<0．001)。剖宫产重度产后出血的病因主要是胎盘因素和子宫收缩乏力,而胎盘因素占首位。结论:胎盘因素是引起剖宫产重度产后出血的主要病因。防治措施关键在于加强产前宣教及产时保健,提高助产技术质量,开展镇痛分娩,严格掌握剖宫产指征,降低剖宫产率。

Objective： To study correlative factors , prevention and treatment methods of severe postpartum hemorrhage （PPH）. Methods; 65 patlents with severe postpartum hemorrhage after cesarean section from January 1997 to June 2005were inclyeled. Severe PPH was defined as blood loss more than 1000 ml or with shock. Results：The incidence rate of severe PPH after cesarean section was 0. 25%. Among them,87.6% cases occurred between delivery and 2h after child birth, while the incidence of severe PPH in vaginal delivery was 0. 14%. The main risk factors of severe PPH afrer cesarean section were platen tal factors and uterine factors. The placental factor were in the first place . Conclusion：The placental factors were the main risk factor which caused severe PPH about cesarean section, methods reduce the incidence of severe PPH about cesarean sec tion can be listed as follow , strengthens the pre-natal child birth way when the propaganda education and the child birth health care, improve the midwifery technology quality, develop analgesia child birth,and master the indication of cesarean section strictly can efficiently reduce the incidence of cesarean section.