摘要
目的探讨晚期产后出血(LPH)的高危因素、病因及其临床特征,为提高其临床诊治水平提供参考。方法收集广州医科大学附属第三医院100例LPH患者作为研究对象,并对其一般资料、晚期产后出血率及高危因素、出血原因、临床特征、症状、出血量进行回顾性分析。结果分娩共50 010例,产后出血孕妇768例(1.53%),LPH 100例(0.20%),其中阴道分娩LPH发生率0.13%,剖宫产LPH发生率0.28%;剖宫产分娩孕妇LPH发病率明显高于阴道分娩,且阴道分娩产妇出血量(518.3±31.9)mL明显低于剖宫产组(769.3±13.7)mL,差异有统计学意义(P<0.05);阴道分娩组LPH主要由胎盘胎膜残留所致,而剖宫产组主要是由切口愈合不良所致;剖宫分娩组突发性出血率、持续性出血率及子宫压痛率均明显高于阴道分娩组,差异有统计学意义(P<0.05)。结论筛查高危妊娠,做好产程管理;产后密切注意产妇身体情况,鼓励阴道分娩等可降低LPH发生率。
Objective To investigate the high-risk factors, causes and clinical characteristics of late postpartum hemorrhage （LPH） , and provide references for improving the level of clinical diagnosis and treatment. Methods A total of 100 patients with LPH in our hospital were enrolled in this study, and their complete and general data, the incidence of LPH, high-risk factors, bleeding reasons, clinical characteristics, symptoms and bleeding volume were analyzed retrospectively. Results There were 50 010 cases of pregnant women delivering in our hospital, and among them, there were 768 cases with postpartum hemorrhage （1.53%） and 100 cases with LPH （0.20%）. The incidence of LPH after vaginal delivery was 0.13%, while that after cesarean section was 0.28%. The incidence of LPH in pregnant women undergoing cesarean section was significantly higher than that in those undergoing vaginal delivery, and the bleeding volume of pregnant women undergoing vaginal delivery [ （518.3 ± 31.9） mL] was significantly less than that of women undergoing cesarean section [ （769.3±13.7） mL] （P〈0.05）. LPH in the vaginal delivery group was mainly caused by residual placenta and fetal membranes, whereas that in the cesarean section group was mainly caused by poor healing of the incision. The incidence rates of sudden bleeding, persistent bleeding and uterine tenderness in the cesarean group were significantly higher than those in the vaginal delivery group （P〈0.05）. Conclusion Screening high-risk pregnancy, good process management, paying attention to maternal conditions after delivery and encouraging vaginal delivery can reduce the incidence of LPH.
作者
梁润仪
李映桃
李柱
LIANG Run-yi LI Ying-tao LI Zhu(Department of Obstetrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China)
出处
《热带医学杂志》
CAS
2017年第8期1071-1074,共4页
Journal of Tropical Medicine
关键词
晚期产后出血
高危因素
临床特征
Late postpartum hemorrhage
High-risk factors
Clinical characteristics
