晚期产后大出血120例的临床分析及防治

Clinical analysis and prevention and treatment of 120 cases of late postpartum hemorrhage

目的探究120例晚期产后大出血产妇的临床治疗及防治。方法回顾性分析2010年2月-2013年2月百色市中医医院收治的120例晚期产后出血产妇的临床资料,并采用多因素Logistic回归分析晚期产后大出血的相关危险因素。结果胎盘胎膜残留是导致晚期产后出血的主要病因,发生率为51.7%;产褥感染和胎盘胎膜残留所引起产后出血的发病时间相对较短,分别于产后3~12 d和6~14 d发生产后出血;切口裂开出血量最多,为（2680.7±284.6）ml。多因素Logistic回归分析后得出,胎盘胎膜残留、子宫复旧不良、产褥感染、切口裂开是晚期产后大出血的危险因素。所有患者均经对症治疗后,得以有效控制出血,治愈率为100%。结论晚期产后大出血病情较凶险,为此需加强围产期预防,减少大出血的发生。

Objective To make clinical analysis and prevention and treatment of 120 cases of late postpartum hemorrhage.Methods A retrospective analysis on clinical data of 120 cases of advanced maternal postpartum hemorrhage in our hospital from February 2010 to February 2013 was conducted. Multivariate Logistic Regression Analysis was used to analyze related risk factors of late postpartum hemorrhage. Results Residual placenta membrane was a major cause of late postpartum hemorrhage,the incidence was 51. 7%; the onset time of postpartum hemorrhage caused by puerperal infection and residual of placental membranes was relatively short and occurred 3- 12 days and 6- 14 days respectively after delivery. The amount of bleeding was the largest in wound dehiscence as（ 2680. 7 ± 284. 6） ml. Multivariate Logistic Regression Analysis,showed that residual placental membranes,poor uterine involution,puerperal infection and wound dehiscence were risk factors for late postpartum hemorrhage. All postpartum hemorrhage were effectively controlled after symptomatic treatment with a cure rate of 100%. Conclusion The late postpartum hemorrhage condition was more dangerous so that strengthening of perinatal prevention was needed to reduce the incidence of serious bleeding.