产后出血行急症子宫切除术的相关危险因素分析

Analysis on the Related Risk Factors of Emergency Hysterectomy for Patients with Postpartum Hemorrhage

目的分析产科急症子宫切除术治疗产后出血患者的相关危险因素。方法选择武汉市第五医院2008年2月至2013年2月收治的产科产后出血行急症子宫切除术治疗的患者47例作为观察组,同期选择45例产后出血未行急症子宫切除术治疗的患者作为对照组。比较两组患者前置胎盘、胎盘早剥、胎盘植入、子宫破裂、子宫肌瘤、双胎妊娠、胎位异常、弥散性血管内凝血(DIC)、出血量多和妊娠期高血压综合征的发生率,分别采用单因素和多因素方法筛选出相关危险因素。结果单因素分析结果显示,观察组在前置胎盘、胎盘早剥、胎盘植入、子宫破裂、子宫肌瘤、DIC、出血量多的发生率高于对照组,差异有统计学意义(P<0.05);Logistic多因素回归分析结果显示,前置胎盘、胎盘早剥、胎盘植入、子宫破裂和DIC均为子宫全切除术发生的危险因素(P<0.01)。结论子宫切除术与多种因素有关,加强对妇女患者的监测、提高警惕、减少子宫切除术的发生。

Objective To analyze the related risk factors of emergency hysterectomy in treating patients with postpartum hemorrhage.Methods A total of 47 patients with postpartum hemorrhage treated with emergency hysterectomy in Wuhan Fifth Hospital from Feb.2008 to Feb.2013 were selected as the observation group,another 45 patients with postpartum hemorrhage not treated with emergency hysterectomy in the hospital during the same period were selected as the control group.The incidence of placenta previa,placental abruption,placenta accreta,uterine rupture,uterine fibroids,twin pregnancy,fetal abnormalities,disseminated intravascular coagulation（DIC）,large amount of bleeding and gestational hypertension of the two groups was compared.The relevant risk factors were picked out using univariate and muhivariate Logistic regression method.Results Results of univariate analysis showed that：the incidence of placenta previa,placental abruption,placenta accreta,uterine rupture,uterine fibroids,DIC,large amount of bleeding of the observation group was higher than the control group,there was statistically significant difference（P 〈 0.05）.Results of muhivariate Logistic regression analysis showed that：placenta previa,placental abruption,placenta accreta,uterine rupture and DIC were the risk factors of hysterectomy（P 〈 0.01）.Conclusion Hysterectomy is related with variety of factors,enhancing the monitor of women patients can reduce the applicantion of hysterectomy.