剖宫产产后出血的相关危险因素调查及干预措施

The Investigation and Interventions of Cesarean Risk Factors Associated with Postpartum Hemorrhage

目的分析引起剖宫产术产后出血的相关危险因素及探讨对产后出血的干预措施。方法将我院52例剖宫产术产后出血患者和同期52例阴道分娩孕妇进行统计学分析,明确引起剖宫产术产后出血的相关危险因素,总结分析对剖宫产术产后出血患者的干预措施。结果剖宫产术术后出血发生率显著高于阴道分娩者(χ2=15.16,P<0.01),且出血量显著多于自然分娩者(t=5.18,P<0.01);高龄、前置胎盘、巨大儿、双胎妊娠、血小板低、应用宫缩抑制剂是引起剖宫产术后出血的危险因素;子宫收缩乏力、胎盘因素为剖宫产术产后出血的主要原因。38例通过常规止血治疗完成止血,1例行子宫次全切除术完成止血,其它经宫腔填塞纱布术、B-Lynch缝合术、双侧子宫动脉上行支结扎术完成止血。结论避免产后出血危险因素、严格掌握剖宫产术手术适应证,有助于降低剖宫产术产后出血的发生率;明确产后出血原因与制定科学合理止血方案可降低产后出血对产妇健康的影响。

Objective To analyze the risk factors associated with postpartum hemorrhage of cesarean section and explore effective interventions to resolve it. Methods 52 cases of cesarean section and the same period 52 cases of vaginal delivery of pregnant women were statistically analyzed to explore risk factors to cause postpartum hemorrhage and summary the interventions to heal it. Results The incidence of cesarean section postpartum hemorrhage and bleeding were significantly higher than the vaginal delivery group （X2 = 15.16 ,P 〈 0.01 ; t = 5. 18, P 〈 0.01 ） ; senior citizens, placenta previa, huge children, twin pregnancy, low platelet application tocolytic risk factors that cause hemorrhage after cesarean section;mainly due to uterine at- ony, placental factors for cesarean section postpartum hemorrhage ;38 cases of pregnant women through routine program, 13 cases through a special way, by the removal of the uterus to achieve hemostasis. Conclusion Avoid risk factors, to master the indications for cesarean section, reasonable to develop hemostatic plan, and help to reduce the incidence of bleeding to improve maternal health.