产科出血性休克131例临床分析

CLINICAL ANALYSIS OF 131 CASES oF OBSTETRIC HEMORRHAGIC SHOCK

目的：探讨产科出血性休克发生的原因和防治措施。方法：对20年产科出血性休克131例进行回顾性分析。结果：产科出血性休克发生率为0．47％，宫缩乏力仍是出血性休克的首要原因；主要危险因素是好高征、剖宫产。结论：加强产程观察，严格掌握剖宫产适应证，降低剖宫产率，提高产科各种手术质量，可有效地预防产科出血性休克的发生；同时还表明，剖宫产术中肌瘤剔除术不是出血性休克的原因，但肌瘤可影响产后子宫收缩而导致出血。

Objective: In order to find causes and praventive methods of obstetric hemorrhagic shock.Methods:Clinical data of 131 cases of obstetric hemorrhagic shock were evaluated retrospectively during20 years. Results: The incidence of obstetric hemorrhagic shock in this study was 0. 47%. Uterine atonyin labor was the most common cause of obstetric hemorrhagic shock(49. 6 % ). The major risk factors included pregnancy induced hypertension (30. 5 % )and cesarean section (39. 7 % ). Conclusion: To maintainconstant observation of the progress of labour and delivery,to master strictly the indications of cesareansection,to reduce the incidence of cesarean section rate and to promote the quality of the obstetric operation are the importent(factors)to prevent obstetric hemorrhagic shock. Although myomectomy isn't thecause of obstetric hemorrhagic shock,the myoma in pregnancy may weaken the uterine retration andlead to hemorrhagic shock.