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目的分析临产孕妇的产前凝血功能检查指标,探讨这些指标与产后大出血的相关性。方法选取2011年3月-2012年3月间本院临产产妇183例,另选取非孕产妇158例作为对照组。收集两组的纤维蛋白原(Fg)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、D-二聚体(DD)、抗凝血酶Ⅲ(AT-Ⅲ)等出凝血功能检查指标和临床资料。分析两组间及孕产妇组内产后出血组与非出血组间实验室检查指标差异性。结果 PT、TT、AT-Ⅲ明显低于对照组,Fg和DD水平明显高于对照组;发生了产后大出血的孕妇的出凝血指标Fg、DD及AT-Ⅲ与未发生产后大出血的孕妇组相比差异具有统计学意义(P<0.05),以Fg≥7.00g/L来诊断产后大出血,其阳性预测值是87.5%,阴性预测值是82.3%;以AT-Ⅲ≤205mg/L,其阳性预测值是85.7%,阴性预测值是82.0%;而以DD≥650mg/L,其阳性预测值和阴性预测值均是100%。结论临产孕妇的凝血功能指标与非孕产妇相比有显著差别,根据产前监测Fg、DD及AT-Ⅲ的浓度水平对预测产妇产后大出血有重要意义。
Objective To analyze the indexes of prenatal coagulation tests in pregnant women and discuss the correlation between these indexes and postpartum hemorrhage. Methods 183 cases of labor in our hospital from March 2011 to March 2012 were selected, and 158 non-pregnant women were selected as the control group. Collect the coagulation of fibrin (Fg), prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer (DD) and antithrombin Ⅲ Function test indicators and clinical data. Analysis of the differences between the two groups and in the maternal group postpartum hemorrhage group and non-bleeding group laboratory test indicators. Results The levels of PT, TT and AT-Ⅲ were significantly lower than those of the control group, and the levels of Fg and DD were significantly higher than those of the control group. The coagulation indexes Fg, DD and AT-Ⅲ of pregnant women who had postpartum hemorrhage were significantly higher than those of the pregnant women without postpartum hemorrhage The difference was statistically significant (P <0.05), with Fg≥7.00g / L to diagnose postpartum hemorrhage, the positive predictive value was 87.5%, the negative predictive value was 82.3%; AT-Ⅲ≤205mg / L, the positive The predicted value was 85.7%, the negative predictive value was 82.0%; while the DD ≥ 650mg / L, the positive predictive value and negative predictive value were 100%. Conclusions There is a significant difference in coagulation function between non-pregnant women and non-pregnant women. The levels of Fg, DD and AT-III in prenatal care are important for predicting postpartum hemorrhage.