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目的分析产前及产后血浆D-二聚体含量的变化及产后/产前比值与产后出血概率的关系。方法通过监测宁波市鄞州第二医院1758例妊娠末期正常待产孕妇产前及产后D-二聚体的动态、记录产后出血量,评估其预测产后出血价值。结果产前D-二聚体浓度在3.7~6.6mg/L时,发生产后出血率为7.7%,当>6.6mg/L时,产后出血率升为13.0%;当产后D-二聚体浓度迅速升高,达产前的5.1~10倍时,发生产后出血风险率为25.6%,当升高至产前10倍以上时,则产后出血率高达62.1%。结论产前及产后D-二聚体浓度与产后/产前D-二聚体比值越高,发生产后出血的概率及平均出血量就越大。
Objective To analyze the changes of plasma D-dimer and the relationship between postpartum / prenatal ratio and the probability of postpartum hemorrhage in prenatal and postnatal period. Methods By monitoring the prenatal and postnatal D-dimer activities of 1758 pregnant women at the end of gestation in Ningbo Yinzhou Second Hospital, the postpartum hemorrhage was recorded and the value of postpartum hemorrhage was estimated. Results Prenatal D-dimer concentration of 3.7 ~ 6.6mg / L, the incidence of postpartum hemorrhage was 7.7%, when> 6.6mg / L, the postpartum hemorrhage rate rose to 13.0%; when the postpartum D-dimer concentration Rapid increase, up to prenatal 5.1 to 10 times, the risk of postpartum hemorrhage occurred 25.6%, when increased to more than 10 times prenatal, the postpartum hemorrhage rate as high as 62.1%. Conclusion The higher the prenatal and postnatal D-dimer concentration and the ratio of postpartum / prenatal D-dimer, the greater the probability of postpartum hemorrhage and the average amount of bleeding.