剖宫产术后早期产后出血相关因素分析

Analysis of factors associated with primary hemorrhage after cesarean section

目的 探讨剖宫产早期产后出血的原因和影响出血量的因素。方法 对 1997～ 2 0 0 1年 5 5 6例剖宫产早期产后出血病例进行回顾性分析。结果 ①主要原因有子宫收缩乏力 (4 5 9% )、胎盘粘连 (30 8% )、子宫裂伤(18 7% ) ;②出血量 <10 0 0mL占 5 7 4 % ,出血量在 10 0 0～ 2 0 0 0mL之间占 2 9 9% ,出血量 >2 0 0 0mL占 12 8% ;③常规止血方法的成功率为 92 7%、子宫腔纱条填塞为 1 3%、盆腔血管结扎为 3 1%、子宫切除术为 4 0 %。结论 针对出血主要原因 :应选择快速、有效的止血方法 ,应加强胎盘植入的术前预测 ,以减少剖宫产术后出血的发生率。

Objective To discuss the causes of primary hemorrhage after CS and effects of managements on its blood loss.Methods Clinical data of 556 cases of primary hemorrhage after CS during 1997～2001 were analyzed retrospectively.Results ①The causes of hemorrhage were as follows:uterine atony (45.9%),factors associated with placenta (30.8% ),uterine laceration (18.7%).②The case with blood loss less than 1000mL group,in 1000～2000mL group and in more than 2000mL group were 57.4%,29.9% and 12.8%,respectively.③Among 555 cases,the success rates in controlling hemorrhage were conventional methods 92.7%,uterine packing 1.3%,artery ligation 3.1%,and cesarean hysterectomy 4.0%.Conclusion To reduce blood loss,the following is important:adopting rapid and effective methods targeting the causes of hemorrhage;predicting the possibility of the placenta increta before CS and reducing the rates of hemorrhage after CS.