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难产性产后出血高危因素及紧急子宫切除术的疗效观察
作者：李凌
来源：《中国医药科学》2017年第06期
[摘要] 目的 研究难产性产后出血的高危因素，探讨紧急子宫切除术对难产性产后出血的临床疗效。 方法 选取我院产科2014年8月～2015年10月期间收治的分娩产妇192例，其中出现难产性产后出血的68例产妇为观察组，另非难产性产后出血的124例产妇为对照组，比较两组患者一般资料，采用Logistic回归方程分析难产性产后出血的高危因素。将观察组按随机数字表法分为两组，每组各34例，其中34例患者采用宫腔纱布填塞法进行治疗作为观察1组；另34例患者采用紧急子宫切除术治疗作为观察两组，观察紧急子宫切除对难产性产后出血的临床疗效。 结果 对照组、观察组两组患者在年龄、宫缩乏力、胎盘植入、软产道损伤、前置胎盘、凝血功能障碍、妊娠合并症以及新生儿畸形比较，差异有统计学意义（P [关键词] 难产；出血；高危因素；子宫切除术
[中图分类号] R714.4 [文献标识码] A [文章编号] 2095-0616（2017）06-77-04
[Abstract] Objective To study the high risk factors of postpartum hemorrhage due to dystocia and clinical effect of emergency hysterectomy for patients with dystocia. Methods 192 puerperas delivered from August 2014 to October 2015 in our obstetrical department were selected.68 dystocia patients complicated with postpartum hemorrhage were selected as observation group；and 124 patients with postpartum hemorrhage were selected as control group.Through the Logistic regression equation，the high risk factors of postpartum hemorrhage for dystocia patients were analyzed.According to random digital talble method，the patients in observation group were randomly divided into two groups，34 cases in each group.Patients in group one were given the guaze packing in the uterine cavity；and patients in group 2 were given the emergency hysterectomy.The clinical effect was observed. Results The age，uterine inertia，placenta implantation，injury of soft birth canal，placenta previa，coagulation disorder，complications and birth defects for two groups were significantly different（P [Key words] Dystocia；Hemorrhage；High risk factors；Hysterectomy
分娩是女性自然生理现象，而随着全球人口的不断增加，女性分娩率也不断升高，难产的发生率也有明显上升。难产性产后出血是女性分娩难产后出现的常见并发症状，指胎儿分娩后1h内大量出血，并经过常规治疗后出血量仍然超过1500mL的产妇[1]。难产性产后出血由于失血量大，会造成严重并发症的发生，若不及时抢救，甚至威胁产妇生命安全，是造成产妇产后死亡的主要原因之一[2]。因此如何治疗难产性产后出血成为人们关注的重点。由于难产性产后出血患者症状严重，往往常规止血治疗效果不佳，临床建议在常规治疗无效后给予子宫切