产后出血的相关因素分析

Analysis of related factors of postpartum hemorrhage

目的探讨产后出血的高危因素及防范措施。方法选取2015年6月～2017年6月在我院分娩的1456例产妇发生产后出血215例作为观察组,选取其中215例未发生产后出血的产妇作为对照组,对可能引起产后出血的因素进行单因素检验及多元Logistic回归分析,筛选与产后出血相关的高危因素。结果分析表明,流产次数、产次、妊娠期高血压疾病、贫血、血小板减少、胎盘早剥、前置胎盘、胎盘粘连或植入、胎数、胎儿体重、分娩方式、宫缩乏力、产程延长、会阴切开等因素均可引起产妇产后出血,差异有统计学意义(P<0.05);其中流产次数、宫缩乏力、胎盘粘连或植入、会阴切开是引起产后出血的独立危险因素(P<0.05)。结论对引起产后出血的相关因素进行防范,减少流产、多产、巨大儿、多胎及剖宫产率,控制及预防妊娠并发症和合并症,积极预防及应对产程延长和宫缩乏力,有效降低产后出血的发生率。

Objective To explore the high risk factors and preventive measures of postpartum hemorrhage. Methods A total of 215 cases of postpartum hemorrhage in 1456 women who gave birth in our hospital from June 2015 to June2017 were selected as observation group. Additionally, 215 cases without postpartum hemorrhage were chosen as control group. The possible factors triggering postpartum hemorrhage were analyzed by single factor test and multivariate Logistic regression analysis to screen for high risk factors associated with postpartum hemorrhage. Results There were statistical differences in factors like the amount of abortions, parity, hypertensive disorder complicating pregnancy, anemia, thrombocytopenia, placental abruption, placenta previa, placental adhesions and implantation, number of fetuses,fetal weight, delivery mode, uterine inertia, prolonged labor stages, and perineotomy leading to postpartum hemorrhage(P<0.05). Among them, the amount of abortion, uterine inertia, placenta previa, and perineotomy are independent factors of postpartum hemorrhage(P<0.05). Conclusion Prevention on the related factors causing postpartum hemorrhage,reduction of abortion, prolificacy, macrosomia, multiple births and cesarean section rates, control and prevention of pregnancy complications, and active prevention and disposal of prolonged labor stages and uterine inertia can effectively reduce the incidence of postpartum hemorrhage.