剖宫产大出血74例临床分析及防治探究.docVIP

剖宫产大出血74例临床分析及防治探究 　【摘要】目的:探讨剖宫产术中大出血的相关因素和防治措施，有利于减少产后出血的发生，提高孕产妇的健康水平。方法:通过我院1999年1月~2003年12月剖宫产术中大出血74例及同期阴道分娩产后出血病例临床资料，对出血原因、出血量进行对比分析。结果:剖宫产术中大出血发生率与平产相近，但出血量有显著性差异，在严重产后出血中占重要比例(70.4%)。出血原因主要是子宫收缩乏力和胎盘因素，二者比较有显著性差异，但前置胎盘所致术中出血占较高比例(32.43%)。结论:剖宫产术是严重产后出血的危险因素，降低剖宫产率，预防和治疗子宫收缩乏力和胎盘因素，特别是前置胎盘的术中出血是减少产后出血，提高孕产妇健康平安的重要措施。 【关键词】剖宫产；产后出血；防治措施 【Abstract】Objective:Thediscussionsplitsthepalacetoproduceinthetechniquethemassivehemorrhagecorrelationfactorandthepreventingandcontrollingmeasure,isadvantageoustothereducedpost-natalhemorrhageoccurrence,raisespregnantwoman?shealthstandard.Method:InJanuary,1999~2003yearinDecembersplitsthepalacethroughmycourtyardtoproduceinthetechniquethemassivehemorrhage74examplesandthesametimevaginaschildbirthpost-natalhemorrhagecaseofillnessclinicalmaterial,tobleedsthereason,thehemorrhagequantitycarriesonthecontrastanalysis.Finally:Splitsthepalacetoproduceinthetechniquethemassivehemorrhageformationrateandtheequaloutputisclose,butthehemorrhagequantityhassignificancethedifference,accountsfortheimportantproportionintheseriouspost-natalhemorrhage(70.4%).Thehemorrhagereasonmainlyisthewombcontractionfeelsweakwiththeplacentafactor,thetwocomparisonhassignificancethedifference,butthepretageplacentaistheresultofinthetechniquetobleedaccountsforahigherproportion(32.43%).Conclusion:Splitsthepalacetoproducethetechniqueistheseriouspost-natalhemorrhagedangerousfactor,reducessplitsthepalaceproductionrate,thepreventionandthetreatmentwombcontractionfeelsweakwiththeplacentafactor,speciallyinthepretageplacentatechniquethehemorrhageisthereducedpost-natalhemorrhage,enhancesthepregnantwomanhealthsafeimportantmeasure. 【Keywords】Splitsthepalacetoproduce;Post-natalhemorrhage;Preventingandcontrollingmeasure 1临床资料 1.1我院5年内住院分娩产妇3644例，发生产后出血172例，产后出血发生率为4.7%，严重产后出血27例。剖宫产1689例，术中大出血74例，发生率4.38%，严重产后出血19例。平产1759例，产后出血20例，发生率454%，阴道助产196例，产后出血18例，发生率9.17%。 1.2一般情况:74例剖宫产术中出血产妇年龄0~40岁，平均28.4岁;孕周33+6~42+6周，平均38周;初产妇52例，经产妇22例。有1次剖宫产史者9例。有剖宫产指征59例，无剖宫产指征15例。手术麻醉除2例为局麻，其