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目的:研究分析剖宫产与阴道分娩对产妇产后出血量的相关影响。方法:回顾性分析2015年5月至2015年12月杭州市妇产科医院产科收入的分娩初产妇320例,治疗医师按照手术方法不同将所有产妇分为两组,其中A组215例,均行剖宫产术,B组105例,均行阴道分娩术。观察比较两组产妇的怀孕次数、生产次数、分娩孕周、新生儿体重、分娩前后血红蛋白检测值和血红蛋白下降值、分娩前后血细胞比容检测值和血细胞比容下降值,分析产妇采用阴道分娩后出血量的相关影响因素。结果:行剖宫产产妇组的年龄大于行阴道分娩产妇组,且前者的分娩孕周少于后者,差异具有统计学意义(P<0.05);A组产妇分娩前血红蛋白检测值与B组无显著差异,A组产妇分娩后血红蛋白检测值(119.22±12.04)高于B组产妇(117.39±18.75),差异具有统计学意义(P<0.05),两组产妇分娩前血细胞比容检测无显著差异,A组产妇分娩后血细胞比容检测(36.14±4.75)明显高于B组产妇(34.02±3.17),差异具有统计学意义(P<0.05)。采用非参数的秩和检验比较不同干扰因素对阴道分娩产后出血的影响,结果显示阴道分娩产妇采用助产、切开会阴、产后刮宫产后血红蛋白和血细胞比容下降值明显大于切开会阴、产后刮宫阴道分娩产妇,差异具有统计学意义(P<0.05),其他干扰因素不能增加血红蛋白和血细胞比容下降值。结论:孕妇行剖宫产手术时,术者需严格遵照剖宫产相关手术原则进行操作,对产后出血的导致原因应充分掌握并有效避免,完善术前准备及术后护理;术中结扎时缝线需松紧适度,避免未进行彻底缝合或牵拉胎儿脐带过早等情况发生,尽可能防治术后出血,提高患者安全分娩率。
Objective: To study the influence of cesarean section and vaginal delivery on postpartum hemorrhage. Methods: A retrospective analysis of maternity and gynecology hospital in Hangzhou from May 2015 to December 2015, 320 cases of primiparous labor, labor physicians in accordance with the different surgical methods will be divided into two groups of all mothers, of which 215 cases in group A, both Cesarean section, 105 cases in group B, vaginal delivery were performed. Observe and compare the number of maternal pregnancies, the number of births, birth gestational age, newborn weight, hemoglobin and hemoglobin before and after childbirth, the measured value of hematocrit before and after delivery, and the decrease of hematocrit. Related factors of bleeding volume. Results: The age of cesarean section group was higher than that of vaginal delivery group, and the former had less gestational weeks than the latter group (P <0.05). The hemoglobin before delivery in group A was significantly higher than that of group B (119.22 ± 12.04) in group A were higher than those in group B (117.39 ± 18.75), the difference was statistically significant (P <0.05). The hematocrit of the two groups before delivery was insignificant (36.14 ± 4.75) in group A were significantly higher than that in group B (34.02 ± 3.17), the difference was statistically significant (P <0.05). The non-parametric rank sum test was used to compare the effects of different interference factors on postpartum hemorrhage in vaginal delivery. The results showed that the vaginal delivery women adopted midwifery and perineal incision. The postpartum curettage postpartum hemoglobin and hematocrit decreased significantly Vaginal delivery of mothers, the difference was statistically significant (P <0.05), other interfering factors can not increase the hemoglobin and hematocrit decline. Conclusion: When pregnant women undergo cesarean section operation, the surgeon should strictly follow the operation principle of cesarean section, and the cause of postpartum hemorrhage should be fully mastered and effectively avoided, and the preoperative preparation and postoperative nursing should be improved. During the operation, Suture need to be tight and moderate, to avoid not completely suture or pull the umbilical cord premature happen, as much as possible to prevent postoperative bleeding and improve patient safety delivery rate.