孕妇剖宫产前后凝血四项预测产后出血的检验分析

Study on the value of four blood coagulation indexes before and after cesarean section in pregnant women

目的:分析凝血四项对剖宫产孕妇产后出血的预测价值。方法:回顾性分析2011年5月至2015年5月31例孕妇剖宫产后出血临床资料,和同时期健康剖宫产非出血孕妇31例进行生产前后凝血四项比较,观察其在含量上变化情况,并采用多影响因素分析。结果:健康组在凝血四项指标TT、PT、APTT、FIB上比较差异不显著(P>0.05),而产后出血组产后在PT、APTT上显著提高,FIB显著缩短,产前后比较差异显著(P<0.05),而在TT上比较产前后不显著(P>0.05),两组产后在PT、APTT、FIB比较差异显著(P<0.05);且出血量和TT、PT、APTT正相关,和FIB负相关(P<0.05);单因素和Logistic多因素分析,PT、APTT、FIB是产后孕妇剖宫产产后出血的独立危险因素(P分别=0.021、0.017、0.013)。结论:对孕妇剖宫产进行凝血四项检测在预测产后出血上有一定临床价值。

Objectives： To investigate the clinical value of four blood coagulation indexes before and after cesarean section in pregnant women. Methods： A retrospective analysis of clinical data of 31 pregnant women with postpartum hemorrhage of cesarean section from May 2011 to May 2015 was done. 31 healthy pregnant women receiving cesarean section were selected. Four blood coagulation indexes before and after delivery of two groups were compared. And the influence factors were analyzed. Results： The four blood coagulation indexes of Health group and hemorrhage group had no significant difference（ P〈0. 05） before delivery. After delivery,in hemorrhage group,PT and APTT increased significantly,FIB was significantly shortened,with significant difference compared with these indexes before delivery（ P〈0. 05）,and TT had no significant difference before and after delivery（ P〈0. 05）. APTT,PT and FIB in two groups were significantly different（ P〈0. 05）; and the amount of bleeding was positive correlated with TT,PT and APTT and negative correlated with FIB（ P〈0. 05）; analysis of single factor and Logistic multiple factors showed that PT,APTT and FIB were independent risk factors of postpartum hemorrhage after cesarean section（ P = 0. 021,0. 017 and 0. 013）. Conclusion： It is of clinical value to predict postpartum hemorrhage in cesarean section by testing four blood coagulation indexes.