叶雪梅 刘伟武 徐秀英 曾伟兰

[摘要] 目的 探讨剖宫产术后晚期产后出血的相关影响因素及预防措施。 方法 选择2011年1月～2014年12月在我院行剖宫产的产妇8498例，以是否发生晚期产后出血将其分为两组。统计并比较两组孕妇的一般因素和手术相关因素。剖宫产术后晚期产后出血的相关影响因素进行Logistic回归分析。 结果 我院剖宫产术后晚期产后出血发生率为0.31%。BMI≥28 kg/m2、妊娠胎儿数≥2个、剖宫产史、妊娠期合并症、产后营养不良、术后感染、子宫复旧不良、组织对位不佳和夏季手术是剖宫产孕妇术后晚期产后出血的危险因素。行剖宫产孕妇满足危险因素越多，其发生晚期产后出血风险越高。 结论 孕妇发生剖宫产术后晚期产后出血是多因素共同作用的结果。根据每一位孕妇的具体情况，在生产时和产后给予预防措施进行干预对降低剖宫产术后晚期产后出血发生率具有重要意义。

[关键词] 剖宫产；晚期产后出血；影响因素；预防措施

[中图分类号] R719.8+2 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0074-04

The related influence factors for late postpartum hemorrhage after cesarean section and its preventive measures

YE Xue-mei LIU Wei-wu XU Xiu-ying ZENG Wei-lan

Department of Obstetrical，Maternal and Child Health Hospital of Yulin City in Guangxi Zhuang Autonomous Region，Yulin 537000，China

[Abstract] Objective To discuss the risk factors for late postpartum hemorrhage after cesarean section and the preventive measures. Methods 8498 parturients given cesarean section in our hospital were selected from January 2011 to December 2014 and were divided into two groups according to whether or not having late postpartum hemorrhage.The general factors and operation correlative factors of parturients in two groups were gathered and compared.And the related influence factors for late postpartum hemorrhage after cesarean section were analyzed by Logistic regression analysis. Results The incidence rate of late postpartum hemorrhage after cesarean section was 0.31%.BMI≥28 kg/m2，gestation fetus number≥2，cesarean section history，pregnancy complications，postnatal malnutrition，postoperative infection，bad involution of uterus，poor organization registration and taking operation at summer are the risk factors for late postpartum hemorrhage after cesarean section. Conclusion The late postpartum hemorrhage after cesarean section is the result of many factors worked together.Taking some preventive measures made according to each parturient case at giving birth and postpartum nursing to decrease the incidence rate of late postpartum hemorrhage is of great significance.

[Key words] Cesarean section；Late postpartum hemorrhage；Risk factor；Preventive measure

剖宫产是产科临床在危急时刻可以有效挽救母婴生命的重要手段[1-2]。随着人体解剖结构的深入研究和麻醉手段、麻醉药品等医疗科学的发展，现今剖宫产术的安全性极大提高，随之临床剖宫产率明显升高，产后不良事件发生率也有上升趋势[3-6]。晚期产后出血是剖宫产术后常见的并发症之一，严重影响产妇的健康和生命安全[7-8]。本文中以在我院行剖宫产的产妇为研究对象，分析并探讨剖宫产术后晚期产后出血的相关影响因素及预防措施，为临床工作提供参考。……