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目的总结实际工作中预防、降低产后出血的主要措施,为临床工作中防治产后出血提供参考。方法分析2009-2010年陕西省妇幼保健院分娩的5991例产妇产后出血发生率的年度变化,以及相应的防治措施。结果产后出血发生率从2009年的3.59%下降到2010年的2.15%(χ2=10.237,P=0.001)。不同年份的对比发现,积极采取措施,可以降低产后出血的发生率。妊娠巨大儿或双胎的孕妇,剖宫分娩术前静推钙剂或术中胎儿娩出后预防性应用卡前列素氨丁三醇(欣母沛),使产后出血在巨大儿或双胎术中发生率从2009年的26.4%下降到2010年的15.72%(χ2=5.721,P=0.017)。阴道分娩或剖宫分娩过程中胎盘不能自行剥离时,预防性应用欣母沛,使产后出血在胎盘粘连中发生率从2009年的41.10%下降到2010年的23.17%(χ2=5.740,P=0.017)。结论必须有“预防为主”的主导思想,针对不同出血原因积极采取行之有效的防治措施,是降低产后出血发生率的关键。
Objective To summarize the main measures to prevent and reduce postpartum hemorrhage in practical work, and to provide reference for prevention and treatment of postpartum hemorrhage in clinical work. Methods The annual changes of maternal postpartum hemorrhage incidence in 5991 maternal and childbirth areas from 2009 to 2010 in MCH and its prevention and treatment measures were analyzed. Results The incidence of postpartum hemorrhage decreased from 3.59% in 2009 to 2.15% in 2010 (χ2 = 10.237, P = 0.001). Comparison of different years found that proactive measures to reduce the incidence of postpartum hemorrhage. Gestational macrosomia or twins of pregnant women, cesarean section preoperative intravenous calcium or intraoperative fetal delivery after the preventive application of card prostaglandin trometamol (Yan Xin Pei), postpartum hemorrhage in huge or twins In the incidence from 26.4% in 2009 decreased to 15.72% in 2010 (χ2 = 5.721, P = 0.017). Vaginal delivery or cesarean delivery during the placenta can not be self-stripping, prophylaxis Yan Xin Pei, postpartum hemorrhage in the incidence of placental adhesions decreased from 41.10% in 2009 to 23.17% in 2010 (χ2 = 5.740, P = 0.017). Conclusion The main idea of “prevention first” must be taken. Active prevention and treatment measures for different causes of bleeding are the key to reducing the incidence of postpartum hemorrhage.