摘要
目的：探讨不同产后出血量患者的妊娠结局、干预措施及输血情况。方法：回顾性分析我院2010年1月至2014年12月期间产后出血的658例患者的临床资料,并根据出血量〈1500 ml、1500~2500 ml、≥2500 ml进行分组分析。比较不同产后出血量患者的妊娠结局、干预措施及输血情况。结果：〈1500 ml组、1500~2500 ml组、≥2500 ml组3组产妇弥散性血管内凝血（DIC）、失血性休克、肺损伤的发生率比较差异有统计学意义（P〈0.01）。73例因保守措施难以控制而采取了子宫切除术的患者,其出血量中位数达4000 ml。出血量≥2500 ml采取子宫切除的比例显著高于出血量小的组（χ^2=123.1,P〈0.05）。子宫切除组瘢痕子宫、凶险性前置胎盘及羊水栓塞的比例显著高于保守治疗止血组（P〈0.01）。接受输血治疗者中按治疗单位计算输注红细胞悬液∶新鲜冰冻血浆平均数为1∶1.15。结论：对产后出血量进行临床分级,将有助于指导治疗方案、把握治疗时机。针对产科出血特点,需进一步规范产后出血的输血管理。
Objective： To study the influence of different amount of postpartum bleeding on the pregnancy outcome,interventions and blood transfusion strategies. Methods： 658 cases of postpartum hemorrhage from Janurary2010 to December 2014 were retrospectively analyzed,and were divided into three groups（ e. g 1500 ml,1500-2500 ml and≥2500ml group） according to the bleeding volume,then the pregnancy outcome,interventions and blood transfusion strategies were compared among these three groups. Results： Patients were more likely to suffer disseminated intravascular coagulation（ DIC）,hemorrhagic shock and lung injury when the amount of postpartum bleeding was more than 2500ml（ χ^2= 123. 1,P〈0. 05）. Hysterectomy was performed in 73 cases with a median blood loss of 4000 ml. The main indications of peripartm hysterectomy were placenta previa,historyof cesarean section and amniotic fluid embolism. And the mean ratio of RBC transfusion to FFP transfusion was1 ∶ 1. 15. Conclusions： To grade the postpartum hemorrhage is significant for the clinical therapy and surgery timing. Much standardized management for blood transfusion is needed according to the characteristics of postpartum hemorrhage.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2016年第7期541-544,共4页
Journal of Practical Obstetrics and Gynecology
关键词
产后出血
子宫切除术
输血
相关因素
Postpartum hemorrhage
Hysterectomy
Transfusion
Related factors
