产后出血92例临床分析

目的:通过对92例产后出血患者临床资料的回顾性分析,探讨产后出血的发生原因、诊疗方法及其预防措施,以指导产科临床工作。方法:选取收治的、发生产后出血的92例产妇的临床资料为研究对象,进行回顾性分析,探讨产后出血的主要原因、诊断和治疗的方法,并通过病情转归对疗效进行评估以助于制定合理的诊疗方案。结果:92例研究对象来自于同期收治的5 705例孕产妇,产后出血发生率为1.61%(92/5 705);产后出血的高危因素包括前置胎盘、胎盘早剥等妊娠合并症、妊娠高血压疾病、巨大儿、双胎等;出血原因依次为子宫收缩乏力(81例)、胎盘因素(7例)以及软产道裂伤(4例);产后出血时间主要集中在产后24 h尤其是产后2 h内,出血量则以500～1 000 ml为主;经积极治疗,92例患者均抢救成功,有13例患者发生中、重度失血性休克,42例患者进行了临床输血,1例行双侧子宫动脉栓塞治疗,1例因保守治疗无效而施行次全子宫切除术。结论:重视产后观察、早期识别并及时准确的测量失血量、针对病因进行处理、积极防治产后失血性休克是防治产后出血、改善预后、降低孕产妇死亡率的关键。

Clinical analysis of 92 cases of postpartum hemorrhage

Objective Through 92 cases of postpartum hemorrhage retrospective analysis of clinical data,to investigate the cause of postpartum hemorrhage,treatments and preventive measure,and use to guide the obstetric work.Methods Based were treated who occurred postpartum hemorrhage 92 cases of maternal clinical data for study,retrospective analysis to investigate the main reason of postpartum hemorrhage,diagnosis and treatment methods,and through an assessment on the efficacy of disease outcome in order to help develop a reasonable treatment plan.Results 92 subjects were from the same period of 5 705 cases of pregnant women who were treated,incidence of postpartum hemorrhage 1.61%（92/5 705）;Postpartum hemorrhage risk factors include placenta previa,placental abruption and other complications of pregnancy,gestational hypertension,great children,twins,etc;the causes of bleeding were uterine atony（81 cases）,placental factors（7 cases） and the soft birth canal laceration（4 patients）;the postnatal time focused on postpartum hemorrhage 24 h,especially within 2 h post-partum,the amount of bleeding places 500～1 000 ml based,after active treatment,92 patients were successfully rescued,13 patients occurred moderate,severe hemorrhagic shock,42 patients underwent clinical blood transfusion,a routine bilateral uterine artery embolization,1 patient with conservative treatment fails and the implementation of sub-total hysterectomy.Conclusion Emphasis on postpartum observation,early identification and timely and accurate measurement of blood loss,treatment for the cause,to prevent and treat postpartum hemorrhage shock is the prevention of postpartum hemorrhage and improve prognosis,the key to reducing maternal mortality.