剖宫产后出血危险因素分析及护理对策

Analysis of Risk Factors of Postpartum Hemorrhage after Cesarean Section and Nursing Countermeasures

目的分析导致剖宫产产后出血的危险因素以及探究相应的护理对策。方法选择在我院进行剖宫产手术的1890名患者为研究对象。分析记录导致患者出血的危险因素,有针对性地采取护理措施。结果本研究1890例患者中共有54例产后出血,剖宫产产后出血的主要原因分别为宫缩乏力(50.00%)、胎盘粘连(22.22%)和胎盘剥离面出血(12.96%)。与剖宫产产后出血有关的相关因素有:剖宫产时间、是否临产、分娩次数、新生儿体重、有无前置胎盘、胎数和有无子痫前期。将上述具有统计学意义的单因素作为自变量,产后是否出血作为因变量进行多因素Logistic回归分析,结果显示,剖宫产时间、是否临产、有无前置胎盘、分娩次数、新生儿体重、胎数和有无子痫前期七个因素进入回归模型(p<0.05),是剖宫产产后出血的危险因素。结论应当增强对患者的健康宣教和产前检测,提高产妇的危险意识,对有高危因素存在的产妇,要加强产前保健,必要时提前入院待产,密切进行产程观察和产后护理。

Objective To analyze the risk factors of postpartum hemorrhage in cesarean section and to explore the corresponding nursing countermeasures. Method A total of 1890 patients who underwent cesarean section surgery in our hospital were chosen as the study objects. The risk factors that caused hemorrhage were recorded and analyzed, and targeted nursing measures were conducted. Results In this study, 54 cases of postpartum hemorrhage occurred in 1890 patients. The main causes of postpartum hemorrhage were uterine inertia（50.00%）, placental adhesion（22.22%） and placental abruption（12.96%）. The factors related to postpartum hemorrhage included cesarean section time, labor, number of deliveries, weight of newborn, placenta previa or not, number of pregnancy, and pre-eclampsia or not. The significant factors above was taken as independent variables, and postpartum hemorrhage or not was taken as the dependent variable in Logistic regression analysis. The results showed that cesarean section time, labor, placenta previa or not, delivery, birth weight, fetal number and pre-eclampsia or not entered the regression model（p〈0.05）, and were the risk factors of cesarean section postpartum hemorrhage. Conclusion The health education and prenatal testing for the patients should be enhanced to improve the awareness of the risks. For the maternal women with highrisk factors, their antenatal care should be strengthened. If necessary, they should be admitted to hospital early for intense labor observation and postpartum care.