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目的:研究分析孕妇产后出血的常见原因和临床解决对策,为临床实践提供理论依据。方法:回顾性分析2009年3月-2012年11月期间,入住我院住院分娩的90例产后出血的患者进行临床资料,并选取同一时间段在我院接受分娩的正常产妇90例作为对照组,比较两组患者的生理、心理、社会等因素之间的差异,分析影响患者产后出血的重要因素,并给予临床解决对策。结果:本组研究中72例(80.0%)患者的产后出血症状发生于产后2小时内,产程延长特别是在产妇第三产程延长导致的产后出血人数共38人,占42.2%,前置胎盘10人(其中剖宫产8人,顺产2人),占11.1%,妊娠合并肝炎5人,占5.6%,妊娠期高血压疾病5人,占5.6%,妊娠期肝内胆汁淤积症1人,占1.1%,双胎4人,占4.4%,有9人无妊娠合并症,对照组中第三产程延长的人数共6人,占6.7%,前置胎盘3人(均为剖宫产),占3.3%,妊娠合并肝炎5人,占5.6%,妊娠期高血压疾病1人,占1.1%,双胎3人,占3.3%,72人无妊娠合并症。分析结果显示观察组患者发生产后出血的几率明显高于对照组,两组比较差异明显,具有统计学意义,(P<0.05);由于产妇胎盘粘连行胎盘人工剥离后出现子宫出血症状的产妇共35例,占38.9%,与对照组(6/90,6.7%)比较,差异具有明显统计学意义,(P<0.05)。妊娠合并肝炎、前置胎盘、妊娠期高血压疾病、妊娠期肝内胆汁淤积症和双胎等情况,具有较高的产后出血发病率。结论:产后出血是妇科常见的一种严重并发症,有妊娠合并症的产妇发生产后出血的几率增加,应加强临床检查和监护。
Objective: To study the common causes and clinical solutions of postpartum hemorrhage in pregnant women and to provide a theoretical basis for clinical practice. Methods: The clinical data of 90 patients with postpartum hemorrhage admitted to our hospital from March 2009 to November 2012 were retrospectively analyzed. Ninety normal pregnant women receiving delivery at the same time were selected as the control group . The difference between the two groups of patients in physiological, psychological and social factors was compared. The important factors influencing postpartum hemorrhage were analyzed and the clinical solutions were given. Results: 72 cases (80.0%) of the patients in our study had postpartum hemorrhage within 2 hours postpartum. The prolongation of labor and the number of postpartum hemorrhage caused by the prolongation of the third stage of labor were 38 (42.2%), placenta previa 10 (of which 8 were cesarean, 2 were spontaneous), accounting for 11.1%, 5 with hepatitis during pregnancy, accounting for 5.6%, 5 with gestational hypertension, accounting for 5.6%, 1 with intrahepatic cholestasis of pregnancy , Accounting for 1.1%, four pairs of twins, accounting for 4.4%, 9 without pregnancy complications, the control group in the third stage of extension of the total number of 6 people, accounting for 6.7%, placenta previa 3 (cesarean section ), Accounting for 3.3%, 5 cases of hepatitis with pregnancy, accounting for 5.6%, 1 hypertensive disorder in pregnancy, accounting for 1.1%, 3 pairs of twins, accounting for 3.3%, 72 without pregnancy complications. The results showed that the incidence of postpartum hemorrhage in the observation group was significantly higher than that in the control group, with significant difference between the two groups (P <0.05); as a result of maternal placental adhesions placenta artificial bleeding after the emergence of symptoms of uterine bleeding 35 cases, accounting for 38.9%, compared with the control group (6 / 90,6.7%), the difference was statistically significant (P <0.05). Pregnancy with hepatitis, placenta previa, gestational hypertension, intrahepatic cholestasis of pregnancy and twins, etc., have a higher incidence of postpartum hemorrhage. Conclusions: Postpartum hemorrhage is a common gynecological complication. The risk of postpartum hemorrhage is increased in pregnant women with pregnancy complications, and clinical examination and custody should be strengthened.