产后出血量的评估及其产后出血相关因素的探讨.pdfVIP

万方数据 目 录 论文摘要 中文摘要 ··························································2 英文摘要 ··························································4 研究内容 前 言 ··························································6 第一部分 实际测量产后出血量与临床估算 产后出血量的比较 资料与方法 ·······················································7 结果 ································································9 讨论 ·······························································12 第二部分 产后出血相关因素的探讨 资料与方法 ······················································15 结果 ·······························································20 讨论 ·······························································25 结 论 ·························································29 参考文献 ·························································30 综 述 ·························································35 致 谢 ·························································42 万方数据 中文摘要 产后出血量的评估及产后出血相关因素的探讨 目的：通过实际测量出血量与临床估算出血量进行比较，旨在说明产后出血量准确测量的重 要性；探讨产后出血相关因素及寻求有价值的高危因素评分方法。 方法：回顾性研究我院 2011 年 03 月 30 日－2011 年 05 月 30 日分娩 141 例孕妇的临床资料， 用体积法+称重法准确测量产妇产后 24 小时的出血量，分析其临床表现、孕期情况、产科合 并症，了解产后出血相关因素，通过 logistic 回归分析筛选出危险因素；并根据全身因素、 人流刮宫史、妊娠期高血压疾病、前置胎盘/胎盘早剥、宫高、血红蛋白、血小板、影响凝血 机制的疾病、羊水过多/多胎妊娠、妊娠合并子宫肌瘤、产程进展、分娩方式、第三产程时间、 胎儿体重、胎盘残留/滞留/植入等 15 项相关因素制成评分表，进行评分。根据评分值与产 后出血的相关性分析及 logistic 回归分析结果评价该高危因素评分表的临床价值。 结果：（1）141 例孕妇测量 24 小时平均出血量为 418.19±174.08ml，临床估算产后出血量平 均为 202.38±92.02ml；实际测量产后出血共 27 例，产后出血率为 19.15%；临床估算产后出 2 血共 4 例，产后出血率为 2.84%；两者产后出血率比较， χ=19.172，P＜0.05，即实际测量 产后出血率高于临床估算出血率。 （2）实际测量产后出血量与临床估算差值呈正相关关系，两者的 Spearman 相关系数 r=0.858，P0