凝血及纤溶指标检测与产后出血的关系研究

目的探讨常规凝血及纤溶指标的变化与产后出血的关系。方法对82例产后出血患者根据产后出血量的不同分为三组：少量出血组26例,出血量500～1 000 ml;大量出血组32例,出血量〉1 000 ml;对照组24例,为正常孕产妇,出血量〈500 ml。定量检测三组产时及产后48 h常规凝血指标血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）及D-二聚体（D-D）、血小板（PLT）、血红蛋白（HGB）。结果与对照组比较,少量出血组PT、APTT、TT、D-D均明显升高（P〈0.05或P〈0.01）,而FIB、HGB、PLT均明显降低（P〈0.05或P〈0.01）;与少量出血组比较,大量出血组PT、APTT、TT、D-D均明显升高（P〈0.01）,而FIB、HGB、PLT则明显降低（P〈0.01）。结论产后及时监测常规凝血及纤溶指标的变化对于了解产妇机体凝血功能以及产后出血的发生从而降低孕产妇病死率具有重要意义。

Research on the correlation between routine coagulation and fibrinolysis index detection with postpartum hemorrage

Objective To study the correlation between routine coagulation and fibrinolysis index detection with postpartum hemorrhage.Methods 82 patients with postpartum hemorrhage were divided into two groups according to the quantity of bleeding（26 patients in slight bleeding group,hemorrhage 500-1 000ml;32 patients in massive bleeding group,postpartum hemorrhage more than 1 000ml） and 24 patients with normal deliveries as control.48h routine coagulation index such as prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（FIB）,D-D,blood platelets（PLT）,hemoglobin（HGB） were detected during the end after delivery.Results Compare with the control group,the values of PT,APTT,TT,D-D of the slight bleeding group were higher（P〈0.05 or P〈0.01）,however,the values of FIB,HGB,PLT were lower（P〈0.05 or P〈0.01）;Compare with the slight bleeding group,the values of PT,APTT,TT,D-D of the massive bleeding group were higher（P〈0.01）,the values of FIB,HGB,PLT were lower（P〈0.01）.Conclusion It has important clinical significance to timely monitor routine coagulation and fibrinolysis index after delivery for understanding the coagulation function of parturient and preventing postpartum hemorrage and then decrease the fatality rate of parturient.