产后出血原因分析与护理体会
2022-06-09
[摘要] 目的 分析引起产后出血的相关因素，探讨引起产后出血的原因及采取的相应护理措施。 方法 对2010年1月～2013年12月本院产后出血患者的出血原因进行回顾性分析。 结果 本组1856例分娩产妇中，发生产后出血56例，发生率为3.02%，出血主要原因为宫缩乏力、胎盘因素、软产道裂伤等危险性因素，分别占75.00%、12.50%和8.92%。产后出血与分娩方式有一定联系，剖宫产的产后出血率为4.85%明显高于自然分娩的1.93%，两组比较差异有统计学意义（P<0.01）;同时，有流产史、两次以上产次和胎儿体重>4000g者，产后出血率会更高。 结论 产后出血发生率与多种危险因素相关。加强孕前宣教及孕期管理、重视产前保健、控制剖宫产、提高助产技术、加强产后观察和急救护理可减少产后出血的发生。产后出血的预防、监测，是减少产后出血的重要环节。
[关键词] 产后出血;危险因素;护理对策
[中图分类号] R473.71 [文献标识码] B [文章编号] 2095-0616（2015）02-102-03
Analysis of the causes of postpartum hemorrhage and nursing experience
LUO Yurong
The Seventh People's Hospital of Chengdu， Chengdu 610044， China
[Abstract] Objective To analyze the related factors of postpartum hemorrhage， to explore the causes of postpartum hemorrhage and the corresponding nursing measures. Methods From 2010 January to 2013 December to our hospital between postpartum hemorrhage cause bleeding were retrospectively analyzed. Results The group of 1856 patients in childbirth， postpartum hemorrhage in 56 cases， the incidence rate was 3.02%， the main reason for the risk of hemorrhage uterine inertia， placenta factors， the soft birth canal laceration and other factors， accounted for 75.00%， 12.50% and 8.92%. Postpartum hemorrhage had some relations with the mode of delivery， the rate was 4.85% higher than that of natural childbirth 1.93% cesarean section postpartum hemorrhage， there was significant difference between two groups（P<0.01）; at the same time， abortion history， two times above parity and fetal weight >4000g， postpartum hemorrhage rate will be higher. Conclusion The incidence rate of postpartum hemorrhage and a variety of risk factors. Strengthen the pre pregnancy and pregnancy missionary management， pay attention to prenatal care， control of cesarean section， and improve midwifery technology， strengthening postpartum observation and emergency nursing care can reduce the incidence of postpartum hemorrhage. The prevention and monitoring of postpartum hemorrhage， is the important link of reducing postpartum hemorrhage.
[Key words ] Postpartum hemorrhage; Risk factors; The nursing countermeasures
产后出血是产科严重并发症，是目前孕产妇死亡的主要原因之一[1]。胎儿娩出后24h内失血量超500mL者称为产后出血，发生率约占分娩总数的2%～3%[2]，产后出血多发生于产后2h，占24h内总出血的1/3～2/3，短时间内的大量失血容易导致产妇抵抗力降低，发生产褥感染，若不及时有效的止血，休克时间过长还可因脑垂体缺血坏死，并发垂体前叶功能低下，产生产后大出血后遗症—席汉氏综合征。所以防治产后出血是医护工作者的重要任务，加强对产后出血的防治与护理非常重要[3]。本研究对产后出血患者临床资料进行分析，就发病原因、监护方法和护理对策进行探索，以降低产妇发病率和死亡率，现报道如下。
1 资料与方法
1.1 一般资料
2010年1月～2013年12月在我院产科住院分娩产妇1856例，胎儿娩出后24h出血量≥500mL诊断为产后出血[4]。发生产后出血56例，年龄18～43岁，平均（28.0±9.2）岁，出血时间在2h内者49例，占87.5%，在2h～24h者7例，占12.5%。出血量500～2500mL，平均（627.5±365.5）mL。
1.2 产后出血量测量方法
全部病例采用直接收集（盆接法）加称重已知原重量的会阴垫和纱布，所得重量按血液比重1.05，换算成毫升数[5]。
1.3 统计学处理
使用SPSSl3.0软件包对56例产后出血患者各项资料进行统计分析，计数资料比较采用x2检验，P<0.05为差异有统计学意义。
[关键词] 产后出血;危险因素;护理对策
[中图分类号] R473.71 [文献标识码] B [文章编号] 2095-0616（2015）02-102-03
Analysis of the causes of postpartum hemorrhage and nursing experience
LUO Yurong
The Seventh People's Hospital of Chengdu， Chengdu 610044， China
[Abstract] Objective To analyze the related factors of postpartum hemorrhage， to explore the causes of postpartum hemorrhage and the corresponding nursing measures. Methods From 2010 January to 2013 December to our hospital between postpartum hemorrhage cause bleeding were retrospectively analyzed. Results The group of 1856 patients in childbirth， postpartum hemorrhage in 56 cases， the incidence rate was 3.02%， the main reason for the risk of hemorrhage uterine inertia， placenta factors， the soft birth canal laceration and other factors， accounted for 75.00%， 12.50% and 8.92%. Postpartum hemorrhage had some relations with the mode of delivery， the rate was 4.85% higher than that of natural childbirth 1.93% cesarean section postpartum hemorrhage， there was significant difference between two groups（P<0.01）; at the same time， abortion history， two times above parity and fetal weight >4000g， postpartum hemorrhage rate will be higher. Conclusion The incidence rate of postpartum hemorrhage and a variety of risk factors. Strengthen the pre pregnancy and pregnancy missionary management， pay attention to prenatal care， control of cesarean section， and improve midwifery technology， strengthening postpartum observation and emergency nursing care can reduce the incidence of postpartum hemorrhage. The prevention and monitoring of postpartum hemorrhage， is the important link of reducing postpartum hemorrhage.
[Key words ] Postpartum hemorrhage; Risk factors; The nursing countermeasures
产后出血是产科严重并发症，是目前孕产妇死亡的主要原因之一[1]。胎儿娩出后24h内失血量超500mL者称为产后出血，发生率约占分娩总数的2%～3%[2]，产后出血多发生于产后2h，占24h内总出血的1/3～2/3，短时间内的大量失血容易导致产妇抵抗力降低，发生产褥感染，若不及时有效的止血，休克时间过长还可因脑垂体缺血坏死，并发垂体前叶功能低下，产生产后大出血后遗症—席汉氏综合征。所以防治产后出血是医护工作者的重要任务，加强对产后出血的防治与护理非常重要[3]。本研究对产后出血患者临床资料进行分析，就发病原因、监护方法和护理对策进行探索，以降低产妇发病率和死亡率，现报道如下。
1 资料与方法
1.1 一般资料
2010年1月～2013年12月在我院产科住院分娩产妇1856例，胎儿娩出后24h出血量≥500mL诊断为产后出血[4]。发生产后出血56例，年龄18～43岁，平均（28.0±9.2）岁，出血时间在2h内者49例，占87.5%，在2h～24h者7例，占12.5%。出血量500～2500mL，平均（627.5±365.5）mL。
1.2 产后出血量测量方法
全部病例采用直接收集（盆接法）加称重已知原重量的会阴垫和纱布，所得重量按血液比重1.05，换算成毫升数[5]。
1.3 统计学处理
使用SPSSl3.0软件包对56例产后出血患者各项资料进行统计分析，计数资料比较采用x2检验，P<0.05为差异有统计学意义。