116例产后出血防治中的问题

An analysis of existing problems in preventing and managing postpartum hemorrhage

目的:探讨产后出血预防、治疗中应注意的问题。方法:回顾分析我院1995年1月-2002年12月发生的产后出血116例的临床特点。结果:116例产后出血的原因为宫缩乏力、胎盘因素和软产道损伤。在出血量的估计上,存在着不足。剖宫产平均产后出血量高于阴道分娩者(P<0.05)。有人工流产史者产后出血的例数及平均产后出血量均高于无人工流产史者(P<0.05,P<0.01)。存在高危因素者产后出血的例数及平均产后出血量均高于无高危因素者(P<0.01,P<0.01)。社会心理因素对产后出血有影响。催产素、麦角新碱与卡前列甲酯栓联合应用可有效控制产后出血。结论:有效预防、减少和成功控制产后出血的发生,应从多方面着手。

Objective: To study points of attention in prevention and management about postpartum hemorrhage. Methods: 116 cases of postpartum hemorrhage were analyzed from Jane. 1995 to Dec. 2002, retrospectively on its clinical characteristics. Results: Causes on 116 cases of postpartum hemorrhage were uterine inertia and placental factors and injuries of the soft birth canal. It was not adequate about estimating the amount of hemorrhage. The mean amount of postpartum hemorrhage on cesarean section was more than vaginal deliveries (P<0. 05) . The case and the mean amount of postpartum hemorrhage with history of abortion groups were higher than those of others without induced abortion (P<0. 01, P<0. 05) . The same as, with high-risk factors groups were higher than those of others without high-risk factors (P<0. 01. P<0. 01).Social and psychological factors affected on postpartum hemorrhage. Coordinated use of oxytocin, ergometrine and mythyl carprost suppository might control postpartum hemorrhage effectively. Conclusion: It should be considered to prevent, reduce, effectively and control successfully postpartum hemorrhage in many ways.