产后出血患者检测休克指数和舒张压的临床意义

目的探讨休克指数(SI)和舒张压(DBP)应用于评估产后出血的价值。方法选取2016年6月-2017年6月于该院经阴道分娩的200例孕产妇作为研究对象,根据产后24 h内出血情况分为产后出血组(97例)和未出血组(103例)。收集两组产妇的年龄、孕周、妊娠次数、产妇及胎儿情况、产后24 h出血量、产前与产后产妇的血压、心率及SI,并对产妇产前与产后的血红蛋白(Hb)及全血细胞水平进行检测,然后将所得结果进行对比分析。结果产后出血组产妇的总产程、24 h出血量及孕周均高于未出血组,差异均有统计学意义(均P<0. 05);而两组产妇在年龄、妊娠次数、生产次数、新生儿体质量及产前收缩压(SBP)、DBP、HR、Hb方面比较,差异均无统计学意义(均P>0. 05)。产后24 h内各指标对比结果显示,两组产妇24 h内各指标均有浮动,而产后出血组的产妇在24 h时的SBP、DBP、红细胞(RBC)及Hb水平均低于未出血组产妇(P<0. 05),而且产后出血组产妇SI明显高于未出血组产妇,差异有统计学意义(P<0. 05)。Ordinal回归分析结果显示,产妇产后SBP、DBP、SI及Hb均可对产后出血进行评估,对产后出血的发生具有提示作用。结论产后24 h SI和DBP对产妇出血的预测有一定价值。

Feasibility analysis of shock index and diastolic blood pressure in evaluating postpartum hemorrhage

Objective To explore the feasibility of applying shock index and diastolic blood pressure to evaluate postpartum hemorrhage. Methods 200 pregnant and lying-in women who gave birth via vagina in our hospital from June 2016 to June 2017 were selected as the research objects. According to the situation of postpartum hemorrhage within 24 hours,they were divided into postpartum hemorrhage group( 97 cases) and non-hemorrhage group( 403 cases). Age,gestational weeks,number of pregnancies,maternal and fetal conditions,24 h postpartum hemorrhage,blood pressure,heart rate and shock index of prenatal and postpartum women were collected. The levels of hemoglobin( Hb) and whole blood cells of prenatal and postpartum women were detected,and then the results were compared and analyzed. Results The total duration of labor,24-hour bleeding volume and gestational week in the postpartum hemorrhage group were higher than those in the non-hemorrhage group,and the difference between the two groups was statistically significant( P<0. 05),while there was no significant difference in age,number of pregnancies,number of births,neonatal weight and prenatal SBP,DBP,HR,Hb between the two groups( P<0. 05). The results of comparison of each index within 24 hours after delivery showed that each index of the two groups had fluctuation within 24 hours,while the levels of SBP,DBP,RBC and Hb in the postpartum hemorrhage group were lower than those in the non-hemorrhage group at 24 hours,with significant difference between the two groups( P<0. 05),and the SI of the postpartum hemorrhage group was significantly higher than that of the non-hemorrhage group,with significant difference between the two groups( P<0. 05). Ordinal regression analysis showed that postpartum SBP,DBP,SI and Hb could be used to evaluate postpartum hemorrhage,which could indicate the occurrence of postpartum hemorrhage. Conclusion Shock index and diastolic blood pressure at 24 hours postpartum are valuable in predicting maternal hemorrhage.