产后出血相关危险因素临床分析

贾宝玲1 ，贾建楼2

（1.延安市宝塔区人民医院，陕西 延安，716000；2.洛川县妇幼保健院，陕西 延安，727400）

浏览次数：109次 下载次数：482次

摘要：

目的 分析产后出血的相关危险因素，为产后出血的防治提供参考。方法 我院2013年1月至2016年9月产妇共计4 102 例，发生产后出血者共138例，回顾性统计分析所有产妇的临床资料，以单因素χ2检验筛选产后出血的相关因素，再通过多因素Logistic 回归分析确定上述因素中产后出血的独立危险因素。结果 单因素分析结果表明，胎次、分娩方式、宫缩乏力、产道损伤、前置胎盘、胎盘粘连植入残留、早接触早吸吮是产后出血的显著相关因素（P<0.05）；多因素Logistic回归分析结果显示，宫缩乏力、前置胎盘、胎盘粘连植入残留、产道损伤、胎次、剖宫产是导致产后出血的主要危险因素，而早接触早吸吮是保 护性因素（P<0.05）。结论 临床应加强产前宣教及孕期系统保健，筛查高危因素，加强高危妊娠的管理，减少社会因素剖宫产，提倡早接触早吸吮，以降低产后出血发生率，进而降低产后出血引起的合并症及孕产妇死亡。

关键词：产后出血；危险因素；临床分析

中图分类号：R714.46文献标志码：A文章编号：2096-1413(2017)30-0133-02

Clinical analysis of the related risk factors of postpartum hemorrhage
JIA Bao-ling 1, JIA Jian-lou 2
（1. Baota District People``s Hospital, Yan``an 716000; 2. Maternal and Child Health Care Hospital of Luochuan County,
Yan``an 727400, China）

ABSTRACT: Objective To explore the related risk factors of postpartum hemorrhage, in order to provide reference for the prevention and treatment of postpartum hemorrhage. Methods A total of 4 102 cases of maternal in our hospital from January 2013 to September 2016 were selected, and among them, 138 cases were bleeding after production. A retrospective statistical analysis of all maternal clinical data was performed. The related risk factors for postpartum hemorrhage were screened by single Factor χ2 test, and Multivariate Logistic regression analysis was then used to determine the independent risk factors for postpartum hemorrhage. Results The results of univariate analysis showed that the parity, mode of delivery, birth canal injury, uterine inertia, placenta previa, placenta accreta implantation residual, early contact and sucking were significant related factors of postpartum hemorrhage (P<0.05); Multivariate Logistic regression analysis showed that the uterine inertia, placenta previa, placenta accrete implantation residual, birth canal injury, parity, cesarean section were the risk factors of postpartum hemorrhage, and early contact and sucking was a protective factor of postpartum hemorrhag (P<0.05). Conclusion In order to reduce the rate of postpartum hemorrhage, prenatal education and systematic care during pregnancy should be strengthened, and screen high-risk factors, strengthen the management of high-risk pregnancy, reduce social factors cesarean section, promote early exposure and early sucking, and then reduce the complications and maternal mortality caused by postpartum hemorrhage.
KEYWORDS: postpartum hemorrhage; risk factors; clinical analysis

参考文献：
[1] 肖兵,熊庆.产后出血诊疗进展[J].实用妇产科杂志,2010,26(1):2-4.
[2] 熊庆,梁娟.孕产妇死亡率及死亡构成的变化趋势[J].实用妇产科杂志,2010,26(1):1-2.
[3] 乐杰.妇产科学[M].8 版.北京:人民卫生出版社,2013:224-225.
[4] 谭庆华,吕荣君.产后出血的高危因素与防治[J].中国妇幼保健,2011,26(33):5161-5162.
[5] 张华琳,冯玉敏.产后出血原因及其影响因素的临床分析[J].实用 预防医学,2009,16(2):474-475.
[6] 钟秀蓉,刘静文,林菲.产后出血195 例临床分析[J].临床医药实践,2010,19(9B):1210-1211.