阴道分娩产后出血的高危因素分析及护理对策

High Risk Factors and Nursing Countermeasures of Postpartum Hemorrhage After Vaginal Delivery

目的探讨阴道分娩后产妇出血的高危因素,分析临床预防、急救护理措施。方法回顾性分析医院2021年1月6月收治的1234例经阴道分娩孕产妇产后出血危险因素并采用单因素及Logistic回归分析,提出针对性的护理措施。结果单因素分析结果显示,孕次、产次、孕周、妊娠合并症及并发症、分娩方式是阴道分娩产后出血的高危因素。多因素分析结果显示,孕次[OR=2.554,95%CI(1.035,6.301),P=0.042]、产次[OR=15.389,95%CI(1.814,130.569),P=0.012]、分娩方式[OR=2.131,95%CI(1.209,3.756),P=0.009]、妊娠合并症及并发症[OR=0.323,95%CI(0.131,0.796),P=0.014]是阴道分娩产后出血的独立危险因素。结论经阴道分娩后产妇出血和分娩方式、孕次、产次、妊娠合并症及并发症存在独立危险因素。通过助产士联合指导,及时加强产后出血高危因素的评估,做好体征观察并采用综合护理措施。

Objective To investigate the high-risk factors of postpartum hemorrhage after vaginal delivery,and to analyze the clinical prevention and emergency nursing measures.Methods The risk factors of postpartum hemorrhage in 1234 cases of vaginal delivery were analyzed retrospectively,and univariate analysis and logistic regression analysis were used to propose targeted nursing measures.Results Univariate analysis showed that the number of pregnancies,times of delivery,gestational weeks,pregnancy complications and delivery mode were the high-risk factors for postpartum hemorrhage after vaginal delivery.The results of factor analysis showed that the number of pregnancies[OR=2.554,95%CI(1.035,6.301),P=0.042],the times of delivery[OR=15.389,95%CI(1.814130.569),P=0.012],the delivery mode[OR=2.131,95%CI(1.209,3.756),P=0.009],pregnancy complications[OR=0.323,95%CI(0.131,0.796),P=0.014]were independent risk factors for postpartum hemorrhage after vaginal delivery.Conclusion The delivery mode,times of pregnancy,times of delivery,pregnancy complications are independent risk factors for postpartum hemorrhage after vaginal delivery.It is suggested that we should strengthen the evaluation of high-risk factors of postpartum hemorrhage through the joint guidance of midwives,do a good job in physical signs observation and adopt comprehensive nursing measures.