结合产后出血高危评分的三级预警在预防产后出血的临床应用

Clinical Application of Third-level Early Warning Combined with Postpartum Hemorrhage High-risk Scores in Preventing the Postpartum Hemorrhage

目的采用产后出血高危评分的方法 ,进一步探讨三级预警在预防产后出血的临床应用价值。方法方便选取228名2016年7月—2017年7月在该院经阴道分娩的孕妇,以国家相关部门制定的"产后出血预测分析表"为参考依据,孕妇在入院后和进入产房时由接诊医生对其进行评分,根据高危评分内容,对可控因素进行积极的治疗,对产妇产后的出血量进行统计。结果产后出血预测评分表上的评分越高,产后出血的发生率也就越高,对各组的产后出血情况进行比较,第1~4组产后出血发生率分别为0.44%、1.75%、0.88%、0.44%,差异无统计学意义(P>0.05)。其中高危因素从高到低的排序为:宫底高度(≥32 cm)、第二产程时间(≥30 min)、腹围(≥100 cm)、孕次(≥3次)。其中可以控制的因素有妊娠期高血压(第1~4组分别为0.88%、1.75%、0.88%、0.44%)、妊娠期糖尿病(第1~4组分别为3.95%、2.63%、1.75%、1.32%)、妊娠期凝血功能异常(第1~4组分别为0.00%、0.44%、0.44%、0.44%)、孕妇的进食情况(第1~4组分别为0.00%、0.00%、0.00%、0.44%)等。结论采用产后出血高危评分的三级预警系统,能够对产妇的可控因素进行积极地治疗,也能够更好的帮助医护人员根据评分结果对产妇做好产时和产后出血的抢救准备工作,有效的降低了产妇产后出血的发生率。

Objective To further study the clinical application value of third-level early warning combined with postpartum hemorrhage high-risk scores in preventing the postpartum hemorrhage. Methods 228 cases of delivery women with vaginal delivery in our hospital from July 2016 to July 2017 were convenient selected according to the preventive analysis table of postpartum hemorrhage made by the national related department, after admission, the delivery women were scored by the diagnosis doctors, and the controlled factors were for positive treatment according to the high-risk score contents, and the bleeding volume of delivery women after delivery was counted. Results The higher the score in the postpartum hemorrhage predicative scale, the higher the incidence rate of postpartum hemorrhage, and the incidence rate of postpartum hemorrhage in the first group to the forth group was respectively 0.44%,1.75%,0.88%,0.44%, and the difference was not obvious（P 〉0.05）, without statistical significance, and the high risk factors from high to low were height of fundus（≥32 cm）, second labor course time（≥30 min）, circumference of abdomen（≥100 cm）, pregnancy frequency（≥3 times）, and the controlled factors were the gestational hypertension（the first group to the fourth group 0.88%,1.75%,0.88%,0.44%）, and the gestational diabetes（the first group to the fourth group 3.95%,2.63%,1.75%,1.32%）, abnormal coagulation function during pregnancy（the first group to the fourth group 0.00%,0.44%,0.44%,0.44%）, and the dieting of pregnancy women（the first group to the fourth group 0.00%,0.00%,0.00%,0.44%）. Conclusion The third-level early warning combined with postpartum hemorrhage high-risk scores can better help the medical staff do well in the delivery and postpartum hemorrhage rescue preparation work thus effectively reducing the incidence rate of postpartum hemorrhage of delivery women.