摘要
目的分析凝血四项对剖宫产孕妇产后出血的预测价值。方法选择2015年12月至2018年12月在我院妇产科行剖宫产的100例孕妇作为研究对象,将有产后出血症状(产后出血量>500 mL)的50例剖宫产孕妇作为研究组,50例正常剖宫产孕妇(产后出血量≤500 mL)作为对照组,采用CA-6000型全自动血凝分析仪对血浆进行分析,比较两组孕妇产前、产后的纤维蛋白原(FIB)、凝血酶时间(TT)、凝血酶原时间(PT)及活化部分凝血酶时间(APTT),采用单因素与Logistic多因素回归分析凝血四项指标与产后出血之间的相关性。结果研究组产前、前后FIB、TT无明显差异(P>0.05),PT、APTT则显著增加(P<0.05);对照组产前、产后FIB、TT、PT、APTT均无明显差异(P>0.05);研究组产前、前后FIB、TT均显著低于对照组(P<0.05),PT、APTT则显著高于对照组(P<0.05);将年龄、凝血四项水平等作为变量代入Cox回归模型中进行单因素分析,显示凝血四项与剖宫产孕妇产后出血均有密切关系(P<0.05),均对剖宫产孕妇产后出血有一定预测价值;Logistic多因素回归分析显示,FIB水平是剖宫产孕妇产的出血的独立预测因子,在剖宫产孕妇产后出血方面有较高预测价值。结论在孕妇产前与产后进行凝血四项检测,对于选择剖宫产孕妇的产后出血有较高预测价值,其中FIB可作为独立预测因子,用于指导剖宫产孕妇产后出血预防与处理。
Objective To analyze the predictive value of four items of coagulation in postpartum hemorrhage of pregnant women undergoing cesarean section.Methods 100 pregnant women who underwent cesarean section in gynecology and obstetrics department of our hospital from December 2015 to December 2018 were selected as the study subjects.50 pregnant women with postpartum hemorrhage(postpartum hemorrhage>500 mL)and 50 normal pregnant women(postpartum hemorrhage<500 mL)were selected as the control group.The plasma was analyzed by CA-6000 automatic hemagglutination analyzer and compared between the two groups.Prenatal and postpartum fibrinogen(FIB),thrombin time(TT),prothrombin time(PT)and activated partial thrombin time(APTT)were used to analyze the correlation between four indicators of coagulation and postpartum hemorrhage by single factor and logistic regression analysis.Results There was no significant difference in FIB and TT before and after delivery in the study group(P>0.05),but PT and APTT increased significantly(P<0.05);there was no significant difference in FIB,TT,PT and APTT before and after delivery in the control group(P>0.05);FIB and TT before and after delivery in the study group were significantly lower than those in the control group(P<0.05),while PT and APTT were significantly higher than those in the control group(P<0.05);the four levels of age and coagulation were substituted as variables into Cox.Univariate analysis in the regression model showed that the four factors of coagulation were closely related to postpartum hemorrhage(P<0.05),which had certain predictive value for postpartum hemorrhage of cesarean section pregnant women.Logistic multivariate regression analysis showed that FIB level was an independent predictor of postpartum hemorrhage of cesarean section pregnant women,and had high predictive value for postpartum hemorrhage of cesarean section pregnant women.Conclusion The four blood coagulation tests before and after delivery have high predictive value for choosing postpartum hemorrhage of cesarean section pregnant women.FIB can be used as an independent predictor to guide the prevention and treatment of postpartum hemorrhage of cesarean section pregnant women.
作者
张芳
ZHANG Fang(Department of Center Laboratory,Donggang Maternal and Child Health and Family Planning Service,Donggang 118300,China)
出处
《中国医药指南》
2020年第13期172-173,共2页
Guide of China Medicine
关键词
凝血四项
剖宫产孕妇
产后出血
预测价值
Four items of coagulation
Pregnant women undergoing cesarean section
Postpartum hemorrhage
Predictive value
