产后出血患者中发生严重产后出血危险因素的回顾性分析

Retrospective analysis of risk factors of severe postpartum hemorrhage in patients with postpartum hemorrhage

目的回顾性分析产后出血患者中发生严重产后出血的危险因素,以指导临床早期识别和干预。方法收集371例诊断为产后出血患者,将72例产后出血量≥1500 ml设为研究组,299例产后出血量<1500 ml设为对照组。采用单因素回归分析及二元Logistic回归分析,研究发生严重产后出血的危险因素。结果371例产后出血患者中,高龄产妇发生严重产后出血风险是年轻产妇的3.75倍(OR=3.75,95%CI:1.46~9.64);胎位不正产妇发生严重产后出血风险是胎位正常的3.78倍(OR=3.78,95%CI:1.03~13.89),而合并胎盘植入产妇发生严重产后出血风险是无胎盘植入者的10.53倍(OR=10.53,95%CI:3.53~31.40)。结论高龄产妇、胎位不正及胎盘植入均是严重产后出血的危险因素,需早期识别和早期干预,防止产后出血进一步恶化。

Objective To retrospectively analyze the risk factors of severe postpartum hemorrhage in patients with postpartum hemorrhage,so as to guide clinical early recognition and intervention.Methods 371 patients diagnosed with postpartum hemorrhage were collected.72 patients with postpartum hemorrhage≥1500 ml were enrolled as the study group,and 299 patients with postpartum hemorrhage<1500 ml were enrolled as the control group.Univariate regression analysis and binary Logistic regression analysis were used to study the risk factors of severe postpartum hemorrhage.Results Among 371 patients with postpartum hemorrhage,the risk of severe postpartum hemorrhage was 3.75 times higher in older women than in younger women(OR=3.75,95%CI:1.46~9.64).The risk of severe postpartum hemorrhage was 3.78 times higher in women with misplaced placenta than in women with normal placenta(OR=3.78,95%CI:1.03~13.89),and 10.53 times higher in women with placenta than in women without placenta(OR=10.53,95%CI:3.53~31.40).Conclusion Old age parturient women,misposition of the fetus and placenta implantation are the risk factors of severe postpartum hemorrhage.It is necessary to identify and intervene early to prevent further deterioration of postpartum hemorrhage.