202例第二产程剖宫产术中出血临床分析(1)
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【摘要】 目的 分析202例第二产程剖宫产术中出血原因。方法 对2003年12月至2008年12月在第二产程中行剖宫产术202例病例资料分析,并与同期810例在第一产程行剖宫产的病例作对照组,比较两组术中的出血量,出血的发生率及出血原因。结果 在第二产程行剖宫产术中出血量(368±261)ml和出血发生率(16.3%)均显著高于对照组(P<0.05,P>0.01)。在第二产程行剖宫产出血原因依次为子宫收缩乏力(48.5%),子宫切口裂伤(33.3%),胎盘因素(18.2%),第二产程组发生子宫收缩乏力,子宫切口裂伤的比例明显高于对照组(P>0.05)。结论 在第二产程中行剖宫产是导致产后出血的重要高危因素,子宫收缩乏力,子宫切口裂伤是第二产程剖宫产术中出血的主要原因,因此加强对产妇的评估及产程的观察,做好围手术期的处理,才能减少第二产程剖宫产术,以及术中的出血量和出血的发生率。
【关键词】 第二产程;剖宫产;出血原因
Clinical analysis of intraoperative hemorrhage of 202 patients with cesarean section in the second stage of labor
TIAN Gai-ying.
Department of worker general hospital of Xishan coal group company Taiyuan 030053,China
【Abstract】 Objective To analysis the reason for hemorrhage of 202 Patients with cesarean section in the second stage of labor.Methods 202 patients with cesarean section in the second stage of labor were analyzed during October 2003 to October 2008.and compared with 810 patients in the same period with cesarean section in the first period about the bleeding in the same period.Results The incidence of bleeding and bleeding in study group were significantly higher than those in control group (P<0.01,P<0.05).The bleeding reasons in the second stage group as follows:uterine contractions fatigue (48%),incision laceration(33.3%),placenta factors (2%).
the ratio obviously higher than those in the control group about incision laceration and uterine contractions fatigue(P<0.05).Conclusion The cesarean section in the second stage of labor is an important risk factor which caused postpartum hemorrhage.Uterine contractions fatigue,uterine incision laceration is the main reason intraoperatie bleeding in the second stage.So maternal assessment and observation of delivery should be strengthen,perioperative treatment should be done better.Try to reduce the incidence of complications and intraoperatie bleeding.
【Key words】The second stage of labor;Cesarean section; Bleeding
剖宫产是产科领域中处理难产的重要手段之一,随着科学的进步,手术技术和方式的改进,大大增加了剖宫产手术的安全性,但不可忽视的是剖宫产术中出血是产科常见的并发症,往往短时间内出血量大,危及产妇生命,本文分析了我科近5年来202例病例,进入第二产程行剖宫产术中出血的原因,探讨如何减少在第二产程行剖宫产,以及术中出血量和出血发生率。
1 临床资料
1.1 一般资料 收集2003年12月至2008年12月在我科分娩的产妇共4574例,行剖宫产术2010例,剖宫产率43 ......
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