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目的:探讨剖宫产产后出血的原因及防治措施,以降低剖宫产产后出血发生率及减少剖宫产产后出血量。方法:回顾2012年1月1日至2013年12月31日在安吉县妇幼保健院分娩的4 452例产妇,对其中93例产后出血进行比较分析。结果:剖宫产的产后出血发生率为3.35%,阴道分娩的产后出血发生率为1.02%,两者比较差异有统计学的意义(P<0.05)。剖宫产产后出血原因主要为子宫收缩乏力(72.04%)、胎盘相关因素(23.66%)、子宫切口出血(4.30%)。结论:1剖宫产产后出血发生率比阴道分娩引起的产后出血发生率高,应降低剖宫产率,避免非医学指征剖宫产;2积极有效处理子宫收缩乏力、胎盘相关因素及子宫切口出血是降低剖宫产产后出血发生率及减少剖宫产产后出血量的关键。
Objective: To investigate the causes of postpartum hemorrhage and its prevention and treatment measures to reduce the incidence of postpartum hemorrhage and reduce the amount of bleeding after cesarean section. Methods: A retrospective review was conducted on 4 452 mothers giving birth at the Maternal and Child Health Hospital of Anji from January 1, 2012 to December 31, 2013. 93 postpartum hemorrhages were compared. Results: The incidence of postpartum hemorrhage in cesarean section was 3.35%. The incidence of postpartum hemorrhage in vaginal delivery was 1.02%. The difference between the two groups was statistically significant (P <0.05). The causes of cesarean section postpartum hemorrhage were as follows: uterine atony (72.04%), placenta-related factors (23.66%) and uterine incision bleeding (4.30%). Conclusions: 1 The incidence of postpartum hemorrhage after cesarean section is higher than the incidence of postpartum hemorrhage caused by vaginal delivery, cesarean section rate should be reduced, to avoid non-medical indications for cesarean section; 2 active and effective treatment of uterine atony, placenta-related factors and uterus Incision bleeding is to reduce the incidence of postpartum cesarean section bleeding and reduce the amount of bleeding after cesarean section.