产后出血目测估计与实际测量差异分析及对策.doc

产后出血目测估计与实际测量差异分析及对策 　　[摘要] 目的 分析目测估计产后出血与实际测量产后出血的差异，提高医务工作者的认识，提出规范产后出血计算方法的对策。方法 对2007～2009年在我院分娩的2657例产妇的产后出血情况进行回顾性分析，其中对2007～2008年的产妇根据经验目测估计结合传统容器收集进行目测估计出血量，对2008～2009年采用科学可靠的方法实际测定出血量。比较两组产妇一般资料、产后出血发生率及产后出血量。结果 目测估计产后出血发生率及出血量均明显低于实际测量产后出血发生率和出血量，差异有统计学意义。结论 采用科学可靠的测量方法能及时准确地发现产后出血，及早采取措施防止产妇死亡的发生。 　　[关键词] 产后出血；目测估计；实际测量 　　[中图分类号] R714.46+1 [文献标识码] B [文章编号] 1673-9701（2011）31-112-02 　　 　　Analysis of the Differences between Visual Observation and Actual Measurement of Postpartum Hemorrhage and Propose Countermeasures 　　LI Yulan 　　Longquanyi District Maternal and Child Hospital of Chengdu City in Sichuan Province，Chengdu 610100，China 　　 　　[Abstract] Objective The difference between visual observation and actual measurement of postpartum hemorrhage were analyzed to improve the recognition of medical workers，and strategy can be put forward to regulate postpartum hemorrhage calculation. Methods Postpartum hemorrhage situation of 2657 cases which took place in our hospital from 2007 to 2009 were retrospectively analyzed. From 2007 to 2008 visual observation，combined with the traditional vessel，was used to measure the amount of bleeding，while scientific and reliable methods were applied to calculate the amount of bleeding from 2008 to 2009. Finally，the incidence of postpartum hemorrhage and the amount of bleeding were analyzed. Results The incidence of postpartum hemorrhage and the amount of bleeding of the former were significantly lower than those of the latter，these differences were statistically significant. Conclusion The scientific and reliable measurement can accurately calculate the amount of postpartum blood loss punctually，so measures can be taken timely，which can prevent the death of maternal. 　　[Key words] Postpartum hemorrhage；Visual observation；Actual measurement 　　 　　 　　产后出血是指胎儿娩??后24h内失血量超过500mL，为分娩期严重并发症，居我国产妇死亡原因首位[1]。由于妊娠后期孕妇血容量增加40%～45%[1]，加上胎儿娩出后子宫收缩可增加循环血容量500mL，所以正常产妇可有1000mL左右的失血代偿功能[2]。当产妇出现低血容量症状时，往往提示出血已较多，如果延误抢救时机，则严重威胁孕产妇