产后出血目测估计与实际测量的差异分析及对策(1)
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[摘要] 目的 分析目测估计产后出血与实际测量产后出血的差异,提高医务工作者的认识,提出规范产后出血计算方法的对策。方法 对2007~2009年在我院分娩的2657例产妇的产后出血情况进行回顾性分析,其中对2007~2008年的产妇根据经验目测估计结合传统容器收集进行目测估计出血量,对2008~2009年采用科学可靠的方法实际测定出血量。比较两组产妇一般资料、产后出血发生率及产后出血量。结果 目测估计产后出血发生率及出血量均明显低于实际测量产后出血发生率和出血量,差异有统计学意义。结论 采用科学可靠的测量方法能及时准确地发现产后出血,及早采取措施防止产妇死亡的发生。
[关键词] 产后出血;目测估计;实际测量
[中图分类号] R714.46+1 [文献标识码] B [文章编号] 1673-9701(2011)31-112-02
Analysis of the Differences between Visual Observation and Actual Measurement of Postpartum Hemorrhage and Propose Countermeasures
LI Yulan
Longquanyi District Maternal and Child Hospital of Chengdu City in Sichuan Province,Chengdu 610100,China
[Abstract] Objective The difference between visual observation and actual measurement of postpartum hemorrhage were analyzed to improve the recognition of medical workers,and strategy can be put forward to regulate postpartum hemorrhage calculation. Methods Postpartum hemorrhage situation of 2657 cases which took place in our hospital from 2007 to 2009 were retrospectively analyzed. From 2007 to 2008 visual observation,combined with the traditional vessel,was used to measure the amount of bleeding,while scientific and reliable methods were applied to calculate the amount of bleeding from 2008 to 2009. Finally,the incidence of postpartum hemorrhage and the amount of bleeding were analyzed. Results The incidence of postpartum hemorrhage and the amount of bleeding of the former were significantly lower than those of the latter,these differences were statistically significant. Conclusion The scientific and reliable measurement can accurately calculate the amount of postpartum blood loss punctually,so measures can be taken timely,which can prevent the death of maternal.
[Key words] Postpartum hemorrhage;Visual observation;Actual measurement
产后出血是指胎儿娩出后24h内失血量超过500mL,为分娩期严重并发症,居我国产妇死亡原因首位[1]。由于妊娠后期孕妇血容量增加40%~45%[1],加上胎儿娩出后子宫收缩可增加循环血容量500mL,所以正常产妇可有1000mL左右的失血代偿功能[2]。当产妇出现低血容量症状时,往往提示出血已较多,如果延误抢救时机,则严重威胁孕产妇的生命安全。有文献报道,90%以上的孕产妇死亡是可以避免或经创造条件可以避免的[3,4]。本文通过回顾性分析产后出血目测估计和实际测量的差异,使临床工作人员认识测量产后出血量的重要性,自觉规范产后出血计算方法,为医生临床诊断提供准确依据,从而及时采取有效的处理方法,降低孕产妇死亡率。
1 资料与方法
1.1 一般资料
选取2007年8月1日~2009年7月31日所有在我院分娩的产妇,共计2657人。
1.2 方法
将2007年8月1日~2008年7月31日分娩的产妇共计1422人设为估计组,出血量根据经验目测结合传统容器收集进行估计;将2008年8月1日~2009年7月31日分娩的产妇共计1235人设为实际测量组,每一例产妇出血量采用综合方法(①容积法:对收集的血液使用有刻度的容器测量;②面积法:事先测量经常使用的纱布湿透拧干后的吸血量及治疗巾、剖腹单、产垫单位面积的吸血量 ......
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