摘要
目的调查高危妊娠剖宫产患者术中输血的情况,并分析导致其术中输血的危险因素。方法回顾性分析2015年10月至2022年10月大连市妇女儿童医疗中心集团(春柳院区)收治的100例高危妊娠剖宫产患者临床资料,根据患者术中输血情况将其分为未输血组(43例)、输血组(57例),比较各组患者的基线资料,分析导致高危妊娠剖宫产患者术中输血的主要病种分布,测定各组患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及血红蛋白(Hb)水平,回顾性对比分析高危妊娠剖宫产患者的临床资料、凝血指标及主要病种等数据与患者术中输血的关系,采用二元logistic回归分析高危妊娠剖宫产患者术中输血的危险因素。结果两组胎盘早剥、宫缩乏力、子宫肌瘤和瘢痕子宫的患病率比较,差异无统计学意义(P>0.05);两组胎盘植入、前置胎盘患病率和PT、APTT、TT、Hb水平比较,差异有统计学意义(P<0.05);多因素分析结果提示,Hb(β=-0.975,OR=0.377,95%CI=0.198~0.719)水平升高是影响术中输血的保护因素(P<0.05);合并前置胎盘(β=1.046,OR=2.846,95%CI=1.171~6.916)、合并胎盘植入(β=1.136,OR=3.114,95%CI=1.354~7.164)、PT(β=0.965,OR=2.625,95%CI=1.435~4.800)水平升高是影响术中输血的危险因素(P<0.05)。结论Hb水平升高是影响术中输血的保护因素;合并胎盘植入、前置胎盘和PT水平升高是影响术中输血的危险因素,临床需重点关注这一类人群,做好相关的预防护理措施。
Objective To investigate the situation of intraoperative blood transfusion in high-risk pregnancy patients undergoing cesarean section,and to analyze its risk factors.Methods The clinical data of 100 patients with high-risk pregnancy undergoing cesarean section in Dalian Women and Children's Medical Center Group(Chunliu Hospital)from October 2015 and October 2022 were retrospectively analyzed.According to intraoperative blood transfusion,they were divided into non-transfusion group(43 cases)and transfusion group(57 cases).The baseline data in different groups were compared.The main diseases leading to intraoperative blood transfusion were analyzed.The prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),hemoglobin(Hb)were detected before transfusion.The relationship between clinical data,coagulation indexes,main diseases and intraoperative blood transfusion was retrospectively analyzed.The risk factors of intraoperative blood transfusion were analyzed by binary logistic regression analysis.Results There were no significant differences in prevalence rate between patients with placental abruption,uterine atony,uterine fibroids and scarred uterus between the two groups(P>0.05).There were statistically significant differences in prevalence of placenta implantation and placenta previa,PT,APTT,TT,and Hb levels between the two groups(P<0.05).Multivariate analysis showed that elevated Hb(β=-0.975,OR=0.377,95%CI=0.198-0.719)was a protective factor for intraoperative blood transfusion(P<0.05).Placenta previa(β=1.046,OR=2.846,95%CI=1.171-6.916),placenta accreta(β=1.136,OR=3.114,95%CI=1.354-7.164),PT(β=0.965,OR=2.625,95%CI=1.435-4.800)were risk factors for intraoperative blood transfusion(P<0.05).Conclusion Elevated Hb level is a protective factor for intraoperative blood transfusion,while placenta accreta,placenta previa and elevated PT levels are risk factors for intraoperative blood transfusion.Clinically,this kind of population should be given close attentions to and the corresponding preventive nursing measures should be taken.
作者
宋青洁
郭晓宁
许琦
SONG Qingjie;GUO Xiaoning;XU Qi(Department of Obstetrics,Dalian Women and Children Medical Center(Group)Chunliu Maternity Hospital,Liaoning Province,Dalian116000,China)
出处
《中国当代医药》
CAS
2023年第18期110-113,共4页
China Modern Medicine
关键词
高危妊娠
剖宫产
输血
胎盘植入
前置胎盘
High-risk pregnancy
Cesarean section
Blood transfusion
Placental accreta
Placenta previa
