摘要
目的：探讨引起难治性产后出血的主要危险因素,并分析紧急子宫切除术的治疗效果。方法：2008年6月-2012年5月124例我院收治的难治性产后出血患者124例作为实验组,同期在我院住院的无产后出血产妇124例作为对照组,采用病例对照研究的方法对难治性产后出血产妇的危险因素进行非条件Logistic回归分析；对经保守疗法治疗无效的31例患者行紧急子宫切除术并分析治疗效果。结果：胎盘因素（β=0.95,OR=2.64）、子宫收缩无力（β=1.82,OR=5.48）、妊娠期高血压综合征（妊高征）（β=2.11,OR=6.97）和剖宫产（β=3.78,OR=28.04）是难治性产后出血的危险因素；31例行紧急子宫切除术患者的平均出血量为（2100±198）ml,其中29例（93.5%）经紧急子宫切除术治疗后恢复良好,2例因弥漫性血管内凝血或多脏器功能衰竭而死亡。结论：胎盘因素、子宫收缩无力、妊高征和剖宫产是难治性产后出血的危险因素,应积极防治,对于保守疗法无效的患者行紧急子宫切除术时,应密切关注手术指征及时机,提高手术安全性。
Objective：To investigate the cause of the major risk factors for intractable postpartum hemorrhage and analysis of the therapeutic effect of the emergency hysterectomy.Methods：124 cases of intractable postpartum hemorrhage patients were deemed as experimental group from June 2008 to May 2012,124 cases of postpartum hemorrhage maternal were deemed as the control group over the same period in our hospital.The risk factors of intractable postpartum hemorrhage were analyzed by non-conditional logistic regression with the method of a case-control study.The treatment effect of emergency hysterectomy was analyzed in 31 patients after conservative therapy invalid.Results：Placental factors （β=0.95,OR=2.64）,uterine atony （β=1.82,OR=5.48）,pregnancy-induced hypertension （β=2.11,OR=6.97） and cesarean section （β=3.78,OR=28.04） were the risk factors of intractable postpartum hemorrhage.Average amount of bleeding was （2100±198）ml in 31 cases of patients who routine emergency hysterectomy,29 cases （93.5%） had good recovery after treatment,two cases dead due to disseminated intravascular coagulation,or multi-organ failuredied.Conclusion：Placenta,uterine atony,pregnancy-induced hypertension and cesarean are the risk factors of intractable postpartum hemorrhage,should actively combat. Patients underwent emergency hysterectomy should pay close attention to the indications for surgery and the timing when the conservative treatment ineffective.
出处
《中国医药导刊》
2013年第10期1572-1573,1575,共3页
Chinese Journal of Medicinal Guide
关键词
难治性产后出血
紧急子宫切除术
危险因素
Intractable postpartum hemorrhage
Emergency hysterectomy
Risk factors
