论文部分内容阅读
目的探讨转诊前的处理对产后出血性休克病人预后的影响。方法回顾性分析2005年1月～2008年4月期间在某院救治的该院发生的9例产后出血性休克患者及外院转入的13例产后出血性休克患者分娩方式、出血原因、出血量、救治结局等。结果失血性休克患者,(1)分娩方式比较:该院81.43%为剖宫产,阴道分娩28.57%,院外转入剖宫产15.39%,阴道分娩84.62%;(2)出血原因比较:该院宫缩乏力44.44%,胎盘早剥11.11%,前置胎盘22.22%,疤痕子宫前置胎盘并胎盘植入11.11%,软产道损伤11.11%,院外转入病例中宫缩乏力38.46%,胎盘早剥30.77%,羊水栓塞7.69%,ICP7.69%,胎盘残留15.38%;(3)出血量比较:该院出血量﹤2000ml22.22%,2000～3000ml44.44%,﹥3000ml33.33%,最多出血量为5900ml,院外转入者出血量﹤2000ml7.69%,2000～3000ml69.23%,﹥3000ml23.08%,出血量最高达5000ml。(4)处理措施与预后:外院转入采取补液治疗5例,补液补血治疗6例,2例未做任何处理,转入后死亡3例,死亡患者在外院转诊前处理措施1例为补液治疗,2例未作任何处理即转诊。该院发生失血性休克产妇均给予合理处理,无1例死亡。结论转诊前的处理措施有无及处理措施是否得当与产后失血性休克患者预后密切相关,不做处理即转诊或处理不当转诊的情况下患者死亡率会明显增加。
Objective To investigate the effect of pretreatment on the prognosis of postpartum hemorrhagic shock patients. Methods Retrospective analysis of 9 cases of postpartum hemorrhagic shock patients and 13 cases of postpartum hemorrhagic shock patients transferred to hospital from January 2005 to April 2008 in a hospital for treatment of hemorrhage, causes of bleeding, amount of bleeding , Treatment outcome and so on. Results Hemorrhagic shock patients, (1) comparison of mode of delivery: 81.43% of the hospital for cesarean section, vaginal delivery 28.57%, 15.39% cesarean section transferred to the hospital, vaginal delivery 84.62%; (2) bleeding causes: the hospital 39.4% of uterine atony, 11.11% of placental abruption, 22.22% of placenta previa, scar placenta previa and placenta accreta 11.11%, 11.11% of soft birth canal injury, uterine atony in hospital 38.46%, placental abruption 30.77%, amniotic fluid embolism 7.69%, ICP7.69%, placental residue 15.38%; (3) bleeding comparison: the hospital bleeding <2000ml22.22%, 2000 ~ 3000ml44.44%,> 3000ml33.33%, the maximum bleeding The amount of 5900ml, outpatient bleeding were <2000ml7.69%, 2000 ~ 3000ml69.23%,> 3000ml23.08%, the maximum amount of bleeding up to 5000ml. (4) Treatment measures and prognosis: In the hospital, 5 cases were treated with rehydration therapy, 6 cases were treated with rehydration and blood treatment, 2 cases were treated without any treatment, 3 cases died after transfer, and 1 case was treated with rehydration solution Treatment, 2 cases without any referral. The hospital hemorrhagic shock maternal were given a reasonable treatment, no one died. Conclusion Whether the treatment before referral is appropriate and the treatment is closely related to the prognosis of postpartum hemorrhagic shock patients, the treatment of patients without referral or improper referral will significantly increase the mortality of patients.