摘要
目的回归分析初产妇剖宫产产后出血的相关风险因素。方法选取2022年1—12月在武夷山市立医院妇产科接受剖宫产术的300例初产妇,根据有无发生产后出血将全部初产妇分为产后出血组25例与非产后出血组275例,回顾性分析两组产妇临床资料,并通过单因素与多因素Logistic回归分析对产后出血的相关风险因素进行探讨分析。结果单因素分析结果显示,两组产妇年龄、流产史、凝血功能障碍、产前子宫收缩抑制剂、多胎妊娠、巨大儿、妊娠高血压、剖宫产时机、妊娠糖尿病、子宫收缩乏力、中重度贫血、子宫瘢痕、子宫肌瘤、胎盘粘连或植入或早剥、前置胎盘等比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,初产妇剖宫产产后出血的独立危险因素包括凝血功能障碍、产前宫缩抑制剂、多胎妊娠、子宫收缩乏力、子宫瘢痕、胎盘粘连或植入或早剥、前置胎盘(OR=3.004、4.865、2.568、8.207、2.881、2.951、7.199,P<0.05)。结论初产妇剖宫产后发生产后出血的风险较高,除了剖宫产手术本身外,相关风险因素还包括凝血功能障碍、产前宫缩抑制剂、宫缩乏力、子宫瘢痕、胎盘粘连或植入或早剥、前置胎盘、多胎妊娠等,临床中应针对产后出血的相关风险因素制定有针对性的干预对策,以有效预防剖宫产产后出血。
Objective To regressively analyze the risk factors of postpartum hemorrhage during cesarean delivery in primigravid women.Methods 300 primigravid women who underwent cesarean section in the Department of Obstetrics and Gynecology of Wuyishan Municipal Hospital from January to December 2022 were selected,and all primigravid women were divided into the postpartum hemorrhage group,25 cases and the non-postpartum hemorrhage group,275 cases,according to the occurrence of postpartum hemorrhage or not.The clinical data of the two groups were retrospectively analyzed,and the risk factors associated with postpartum hemorrhage were explored and analyzed by unifactorial and multifactorial logistic regression analysis.Results The results of univariate analysis showed there was statistically significant difference between the two groups in terms of age,history of miscarriage,coagulation disorders,antepartum uterine contraction inhibitors,multiple pregnancy,macrosomia,gestational hypertension,timing of cesarean section,gestational diabetes mellitus,weak uterine contractions,moderately to severely anemic condition,uterine scarring,uterine fibroid tumors,adherence or implantation of the placenta or premature detachment of placenta,placenta previa(P<0.05).The results of multifactorial Logistic regression analysis showed that the independent risk factors for postpartum hemorrhage after cesarean delivery in primigravid women included coagulation dysfunction,antepartum uterine contraction inhibitors,multiple pregnancies,weak contractions,uterine scarring,placental adhesions or implantation or preterm detachment,and placenta previa(OR=3.004,4.865,2.568,8.207,2.881,2.951,7.199,P<0.05).Conclusion The risk of postpartum hemorrhage occurring after cesarean section in primigravid women is high,and in addition to the cesarean section procedure itself,the associated risk factors include coagulation disorders,antepartum uterine contraction inhibitors,lack of uterine contraction,uterine scarring,placental adhesion or implantation or preterm detachment,placenta previa,and multiple pregnancies.In clinical practice,targeted intervention countermeasures should be formulated to effectively prevent postpartum hemorrhage after cesarean delivery by targeting the risk factors related to postpartum hemorrhage.
作者
胡强
钟素萍
HU Qiang;ZHONG Suping(Department of Obstetrics and Gynecology,Wuyishan Municipal Hospital,Wuyishan,Fujian Province,354300 China)
出处
《中外医疗》
2023年第28期18-21,30,共5页
China & Foreign Medical Treatment
关键词
初产妇
剖宫产
产后出血
风险因素
回归分析
干预对策
Primigravida
Cesarean section
Postpartum hemorrhage
Risk factors
Regression analysis
Intervention measures
