瘢痕子宫产妇剖宫产术出血量分析

Analysis of clinical data of blood loss during and after cesarean section in women with scarred uterus

目的观察剖宫产术的瘢痕子宫产妇术中、术后出血量的变化。方法对36例剖宫产分娩的瘢痕子宫产妇，采用称重法精确测量术中、术后出血量，同期选取98例剖宫产分娩的正常产妇作为对照。结果瘢痕子宫组术中出血量为（372．4±180．0）ml，术后2h内总出血量为（444．7±228．2）ml，术后24h内总出血量为（527．4±251．6）ml，均高于对照组（P〈0．05）。瘢痕子宫组产后出血发生率为47．2％，高于对照组（P〈0．05）。瘢痕子宫组与对照组在手术前后Hb及凝血功能变化无明显差异（P〉0．05）。结论瘢痕子宫是导致剖宫产产后出血增加的重要原因，临床处理需加强剖宫产术中失血的防治。

Objective To explore the clinic value of blood loss during and after cesarean section in women with scarred uterus. Methods From July 2007 to December 2008, thirty-six women with scarred uterus received weighing methods to evaluate the actual blood loss during and after cesarean section in Yuhuangding hospital, while 98 cases without pregnant complications were chosen as control. Results In women with scarred uterus, the blood loss during operation was （372.4 ± 180. 0） ml, and the total amount after 2 hours and 24 hours were （444. 7± 228.2 ） ml and （ 527. 4 ± 251.6） ml respectively, which were higher than corresponding values in control group （ P 〈 0. 05 ）. The incidence of postpartum hemorrhage in scarred uterus was 47. 2% , higher than that in control group （ P 〈 0. 05 ）. There were no significant differences between two groups in the tests of hemoglobin and coagulation functions （ P 〉 0.05 ）. Condusions Scarred uterus may be one of the important reasons which lead to postpartum hemorrhage. The clinical treatment of pregnant women with scarred uterus should focus on the prevention of blood loss during the cesarean section.