产科子宫出血病理及产科因素分析

Analysis of Obstetrical Uterine Hemorrhage Pathology and Obstetrical Factors

目的针对产科子宫出血病理以及产科因素进行分析,以此保证产妇的生命安全。方法选择某医院2010年2月—2013年12月收治的50例患者,其基本症状都为产科子宫出血,并且已经进行了子宫切除手术,其主要的方法是回顾性分析法,将患者的资料进行回顾性分析,以此寻找到产生子宫出血的重要原因。结果在子宫出血病理中,宫缩乏力9例,胎盘因素26例,子宫切口感染6例及其他9例,且出血量在500-1 500 m L的有2例,占4.0%,1 500-2 500 m L的有9例,占18%,2 500-3 000 m L的有17例子,占34%,〉3 500 m L的有22例,占44%。在子宫切除主要指征中,胎盘因素为主要因素,占52%。在患者子宫切除影响因素分析中可知,产次越多,产后大出血率越高,即子宫切除发生率越高。剖宫产史、前置胎盘、胎盘植入、宫缩乏力、胎盘早剥与子宫切除发生率差异有统计学意义（P〈0.05）。结论通过明确影响产科子宫出血病理及并发症的主要因素,进而最大程度的降低孕妇发病以及危机生命的机率,从而提供患者生活质量。

Objective The obstetrical Uterine Hemorrhage pathology and obstetrical factors were analyzed to ensure the life safety of puerperant. Methods 50 patients with fundamental symptom of obstetrical Uterine Hemorrhage who had accepted Hysterectomy were selected, and the Retrospective analytical methods was mainly used and their data were retrospectively analyzed by the method so as to find out the key reason of Uterine Hemorrhage. Results In the Uterine Hemorrhage pathology, 9 cases were Uter-ine inertia, 26 cases were related to Placenta, 6 cases were Uterine incision infection, and 9 cases were other condition. The bleeding volume of 2 cases （accounting for 4.0%） were 500-1 500 mL;that of 9 cases （accounting for 18%） were 1 500-2 500 mL;that of 17 cases （accounting for 34%） were 2 500-3 000 mL;that of 22 cases （accounting for 44%） were﹥3000mL. Placenta was the main factor in the Hysterectomy Indications and its proportion was 52%. Through the analysis of factor that affect Uterine Hemorrhage, it was known that more parity resulted in higher postnatal bleeding rates or higher Uterine Hemorrhage incidence. The differences between history of cesarean section, placenta previa, placenta accreta, uterine inertia, abruption and Uterine Hem-orrhage incidence were statistical significant（P〈0.05）. Conclusion Through making clear the main factors that affect the obstetrical Uterine Hemorrhage pathology and complication, the disease incidence and mortality rate of pregnant women could be reduced to the most extent, and their quality of life could be improved.