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目的通过产妇产前、产后血红蛋白值的变化估计产后的出血量,客观了解产后的出血状况。方法回顾分析上海市长宁区妇幼保健2011年7月连续收治的产妇411例,在产前及产后24h分别抽取肘静脉血0.5ml,测定相应血红蛋白值,分析产后血红蛋白值的变化。根据血红蛋白值下降10g/L估计出血400ml[1]的标准,估计产妇产时出血情况。结果 1产后血红蛋白值下降≥13g/L的产妇26.3%(108/411),其中顺产组构成比28.8%(74/257),产钳组构成比73.3%(11/15);剖宫产组构成比16.5%(23/139)。产后血红蛋白值变化在不同分娩方式组的构成比例上的差异有统计学意义(χ2=32.73,P=0.000);2本组病例临床上估计的产后出血比例是4.9%,而按血红蛋白下降值标准估计的产后出血比例是26.3%,两者比较差异有统计学意义(χ2值=77.23,P=0.000)。结论剖宫产组的产后出血比例并不高于顺产组;临床估计的产后出血比例明显低于实际产后出血比例;重新定义产后出血的量及产后出血的比例是需要重视、值得研究的问题。
Objective To estimate the amount of postpartum hemorrhage through changes of maternal prenatal and postpartum hemoglobin, and objectively understand the postpartum hemorrhage. Methods Retrospective analysis of maternal and child health in Shanghai Changning District in July 2011 consecutive treatment of 411 cases of mothers, prenatal and postpartum 24h were drawn 0.5ml elbow venous blood, the corresponding hemoglobin value was measured, postpartum hemoglobin value changes. According to the hemoglobin value decreased 10g / L estimated bleeding 400ml [1] standard to estimate maternal labor-induced bleeding. Results The percentage of postpartum women whose mothers had a> 13g / L decrease in hemoglobin value was 26.3% (108/411), of which 28.8% (74/257) were in the delivery group and 73.3% (11/15) in the forceps group. The cesarean section group Than 16.5% (23/139). Postpartum hemoglobin changes in different modes of delivery groups were statistically different (χ2 = 32.73, P = 0.000); 2 in this group of patients clinically estimated postpartum hemorrhage was 4.9%, according to the standard of hemoglobin decline The estimated proportion of postpartum hemorrhage was 26.3%, with a statistically significant difference between the two (χ2 = 77.23, P = 0.000). Conclusion The proportion of postpartum hemorrhage in the cesarean section group is not higher than that in the native group. The proportion of clinically estimated postpartum hemorrhage is significantly lower than the actual proportion of postpartum hemorrhage. Redefining the amount of postpartum hemorrhage and the proportion of postpartum hemorrhage are important issues to be studied.