刘天娇

南京市妇幼保健院妇产科，江苏南京210004

高龄产妇产褥期恶露出血发病率及其影响因素

刘天娇

南京市妇幼保健院妇产科，江苏南京210004

目的探讨高龄产妇产褥期恶露出血的发病率、原因及治疗方法。方法回顾性分析我院2014年12月～2016年3月240例高龄产妇的临床资料。其中恶露出血20例，发病率为8.33%，选取同期20例20～34岁产褥期恶露出血产妇为对照组，观察并比较两组恶露持续时间以及血性恶露持续时间与分娩方式的关系。结果240例产妇中，高龄组恶露出血持续时间较长；不同的分娩方式，剖宫产组较阴道分娩组恶露出血时间长。两组在恶露持续时间方面差异具有统计学意义（P＜0.05）。结论高龄产妇血性恶露持续时间长，阴道分娩有利于子宫恢复，同时要注意纠正子宫体后位；少数存在子宫器质性病变，需要及时处理。

高龄产妇曰产褥期恶露出血曰发病率曰分娩方式曰子宫后位

[Abstract]Objective To explore the incidence rate，causes and treatment method of lochia and bleeding during puerperium in elderly parturient women.Methods Clinical data of 240 elderly parturient women who were admitted to our hospital from December 2014 to March 2016 were retrospectively analyzed.Among them，there were 20 patients with lochia and bleeding，with the incidence rate of 8.33%.20 parturient women with lochia and bleeding during puerperium（20-34 years old）at the same period of time were selected as the control group.Lasting time of lochia in both groups was observed between two groups，and the relationship between the lasting time of bloody lochia and delivery mode was compared.Results In 240 puerpera，the lasting time of lochia and bleeding in the elderly group was longer；based on different delivery modes，the lasting time of lochia and bleeding was longer in the cesarean section group than that in the vaginal delivery group.The lasting time of lochia was significantly different between the two groups（P＜0.05）.Con鄄clusion The lasting time of bloody lochia in the elderly puerpera is longer.Vaginal delivery is beneficial to uterus recovery，and retroposition of uterus should be corrected；there are a few uterine organic pathological changes，which are required to be managed timely.

[Key words]Elderly parturient women；Lochia and bleeding during puerperium；Incidence rate；Delivery mode；Retroposition of uterus

2015年10月29日，中共十八大五中全会公报宣布，中国将“全面实施一对夫妇可生育两个孩子政策”，在这一政策的导向下，有很多高龄产妇也将面临自己身心健康的严重考验。高龄产妇产褥期出血，伴有大量阴道出血现象，与产后正常出血有着本质上的不同，它具有突然发生一阵冲血、间隙性反复发作等特点，情况严重时会发生头晕、心慌、四肢冰凉、晕厥、休克等情况［1］。因此，有关妇产科专家提醒产妇们，分娩24 h以后出血，可丢失大量凝血物质，导致凝血功能障碍，是造成产妇死亡的主要原因之一，产妇应对此有所了解，不可大意。……