剖宫产产后出血相关危险因素分析

Analysis of Correlated Risk Factors of Postpartum Hemorrhage after Cesarean Section

目的探讨剖宫产产后出血的相关危险因素。方法选择2011年1月至2013年12月在深圳市南山人民医院妇产科实施剖宫产产妇5210例,术后发生出血89例,以发生产后出血的患者为病例组,同时选择未出血的89例剖宫产患者为对照组,研究可能影响产后出血的相关危险因素。结果影响产后出血的因素包括多胎妊娠（OR=2.568,95%CI 1.411~3.724）、前置胎盘（OR=7.199,95%CI 4.663~9.736）、胎盘粘连或植入或早剥（OR=2.951,95%CI 1.735~4.166）、子宫瘢痕（OR=2.881,95%CI 1.683~4.078）、子宫收缩乏力（OR=8.207,95%CI 5.902~10.512）、产前子宫收缩抑制剂（OR=4.865,95%CI 3.073~6.656）、凝血功能障碍（OR=3.004,95%CI 1.771~4.237）。结论剖宫产产后出血并发症发生率仍然较高,应针对这些危险因素采取必要的预防措施,以降低该并发症的发生率。

Objective To explore the risk factors of postpartum hemorrhage after cesarean section . Methods A total of 5210 cases of cesarean section from Shenzhen City Nanshan People′s Hospital from Jan.2011 to Dec.2013 were selected,including 89 cases of postpartum hemorrhage,which were assigned to case group,and another 89 cases without postpartum hemorrhage were assigned to control group.The risk fac-tors of postpartum hemorrhage were analyzed .Results The influencing factors of postpartum hemorrhage after cesarean section included in multiple pregnancy（OR=2.568,95%CI 1.411-3.724）,placenta praevia （OR=7.199,95%CI 4.663-9.736）,placental adherence or implantation or placental abruption （OR =2.951,95%CI 1.735-4.166）,uterus scar（OR =2.881,95%CI 1.683-4.078）,uterine inertia（OR =8.207,95%CI 5.902-10.512）,inhibitor of antepartum uterine contraction （OR =4.865,95%CI 3.073-6.656） and coagulation disorders （OR =3.004,95%CI 1.771-4.237）.Conclusion The incidence of postpartum hemorrhage after cesarean section is still high .Preventive measures at the risk factors should be a-dopted to lower the incidence of the complication .