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目的:探讨基层医院产妇产后出血的原因,总结防治方法。方法:对2012年1月-2014年12月在珠海市红旗医院住院分娩的1324名产妇,其中发生产后出血41例产妇的出血原因、抢救治疗方法及预后进行回顾性分析。结果:经产妇的产后出血比例高于初产妇,差异具有统计学意义(P<0.05);有人工或自然流产史产妇的产后出血比例高于非流产产妇,差异具有统计学意义(P<0.05);剖宫产产妇发生产后出血比例最大,明显高于经阴道分娩方式(P<0.05);子宫收缩乏力引起的产后出血远高于胎盘因素及软产道撕裂伤、凝血功能障碍造成的产后出血,差异具有统计学意义(P<0.05)。产妇予欣母沛深部肌肉注射或子宫宫腔内填塞后止血效果良好,无产妇行子宫切除术;出血性休克的8例产妇中5例输血治疗。41例产后出血产妇均痊愈出院,无死亡病例。结论:产妇的孕产史、分娩方式以及子宫收缩状况、胎盘、软产道撕裂伤等均是影响产妇产后出血的因素,明确病因,早期识别,有效治疗是成功防治产后出血的关键。
Objective: To investigate the causes of maternal postpartum hemorrhage in primary hospitals and to summarize the prevention and treatment methods. Methods: Retrospective analysis was conducted on 1324 maternal in-hospital deliveries in Hongqi Hospital, Zhuhai from January 2012 to December 2014, in which 41 maternal postpartum hemorrhages occurred, the cause of rescue and treatment, and the prognosis. Results: The proportion of postpartum hemorrhage was higher than that of primipara, but the difference was statistically significant (P <0.05). The proportion of postpartum hemorrhage was higher in maternal or abortion than non-abortion ); Cesarean section maternal postpartum hemorrhage was the largest proportion, significantly higher than the vaginal delivery mode (P <0.05); postpartum hemorrhage caused by uterine atony is much higher than placental factors and soft birth canal laceration, coagulation disorders caused by postpartum Bleeding, the difference was statistically significant (P <0.05). Maternal to Xin Pei Pei deep intramuscular injection or uterine intrauterine filling after the hemostatic effect is good, no maternal hysterectomy; hemorrhagic shock in 8 cases of maternal transfusion in 5 cases. 41 cases of postpartum hemorrhage were cured and discharged, no deaths. Conclusion: Maternal history of pregnancy, delivery mode and uterine contractility, placenta, soft birth canal laceration and other factors that affect the postpartum hemorrhage, a clear cause, early identification, effective treatment is the key to successful prevention and treatment of postpartum hemorrhage.