产后大出血高危因素分析及欣母沛的预防效果

目的探讨产妇产后出血的高危因素，并研究欣母沛的预防效果。方法对631例待产妇的临床资料进行回顾性研究，分析引起产后出血的独立危险因素。另将有产后出血高危因素的173例产妇分为治疗组88例和对照组85例，治疗组给予欣母沛，对照纽注射缩宫素及舌下含服米索前列醇。对比两组产妇产后2、24h的出血量，产后出血发生率，并对比产后24h血红蛋白变化水平。结果Logistic回归分析显示，宫缩乏力、剖宫产、胎盘粘连和胎儿巨大是导致产妇产后出血的高危因素。治疗组2、24h出血量均低于对照组（t值分别为4．524、6．575，均P〈0．05），且产后出血发生率及产后24h血红蛋白水平也低于对照组（X2=4．309、t=5．325，均P〈0．05）。结论产后出血的高危因素主要有宫缩乏力、剖宫产、胎盘粘连和胎儿巨大；欣母沛用于预防产后出血效果优于缩宫素及米索前列醇，具有安全、有效等优点，值得临床推广应用。

Analysis of high-risk factors of postpartum hemorrhage and prevention effect of hemabate

Objective To explore the high-risk factors of postpartum hemorrhage and study the preventive effect of hemabate. Methods Retrospective analysis was conducted on clinical data of 631 cases of expectant mother to study the independent risk factors of postpartum hemorrhage. Another 173 cases having high-risk factors of postpartum hemorrhage were divided into treatment group （n = 88 ） and control group （ n = 85 ）. The treatment group was treated with hemabate, while the control group wad injected with oxytocin and given misoprostol. Amounts of bleeding at 2h and 24h after delivery and the incidence of postpartum hemoglobin were compared between two groups. The hemoglobin level at 24h after birth was compared. Results Logistic regression analysis showed that uterine inertia, cesarean delivery, placenta adherence and maerosomia were the high-risk factors of postpartum hemorrhage. The amounts of bleeding of the treatment group at 2h and 24h were significantly less than the control group （ t value was 4. 524 and 6. 575, respectively, both P 〈 0.05 ） , and the incidence of postpartum hemorrhage and the level of hemoglobin at 24h were significantly lower in the treatment group （X2 = 4. 309, t = 5. 325, both P 〈 0.05 ）. Conclusion The high-risk factors of postpartum hemorrhage include uterine inertia, cesarean section, placenta adherence and maerosomia. Hemabate is better than oxytoein in preventing postpartum hemorrhage. It has the advantages of safety and effectiveness, and it is worthy of clinical application.