120例产后出血的相关因素分析及对策探讨

目的探讨产妇产后出血的相关因素及对策。方法回顾性分析120例产妇产后出血的相关因素、治疗对策及产后出血发生的时间。结果产后出血的主要因素：子宫收缩乏力76例（63.33%）,胎盘因素29例（15.00%）,软产道损伤12例（10.00%）,凝血功能障碍3例（2.50%）,其中子宫收缩乏力为最常见原因;胎儿娩出2h内发生产后出血者108例（90.00%）,12例产妇产后出血发生在2h后（10.00%）。子宫收缩乏力的治疗对策为按摩子宫、使用缩宫素、宫腔填塞砂条、B-lynch缝合术、子宫动脉栓塞术、次全子宫切除术;胎盘因素的治疗对策为人工剥离胎盘术、刮宫;软产道损伤的治疗对策为填塞纱布、软产道缝合术,所有患者均好转。结论产后出血发病突然,病情变化快,若抢救不及时可危及产妇生命安全,产妇应认真做好产前检查,加强高危因素管理,医护人员认真判断引起产后出血的原因,针对出血原因进行及时的治疗,以降低产妇的死亡率。

Analysis of the related factors and countermeasures for postpartum hemorrhage

Objective To investigate the related factors and counTermeasures of postpartum hemorrhage.Methods 120 cases of postpartum hemorrhage were taken for retrospective analysis.The related factors,the methods used for postpartum hemorrhage and time of postpartum hemorrhage were analyzed.Results The main factors of postpartum hemorrhage: The uterine atony was in 76 cases,accounting for 63.33%;placental factors were in 29 cases,accounting for 15.00%;the soft birth canal injury was in 12 cases,accounting for 10.00%,the coagulopathy was in 3 cases,accounting for 2.50%.The uterine atony was the most common cause.108 cases occurred within 2h fetus of maternal postpartum hemorrhage,accounting for 90.00%.12 cases of postpartum hemorrhage occurred in 2h,accounting for 10.00%.The treatment of uterine atony were massage the uterus,use of oxytocin,Palace cavity filling sand bar,B-lynch suture,uterine artery embolization,subtotal hysterectomy,placental factors.The treatment strategies for the manual were removal of placenta surgery,curettage.The strategies for the soft birth canal injury were therapeutic the packing gauze and soft birth canal suture.All patients improved.Conclusion The sudden onset of postpartum hemorrhage,the condition changes quickly,without timely rescue may endanger the lives of mothers.The maternal should do prenatal care earnestly to strengthen the management of risk factors.The health care workers should determine the cause of postpartum hemorrhage seriously to make the right reasons for bleeding judgments,and take timely manners to determine the treatment and reduce the reduction of maternal mortality.