阴道分娩产妇产后出血量评估的相关问题研究

发布时间：2018-09-18 09:04

【摘要】：目的:通过血红蛋白校正临床评估阴道分娩产妇产后出血量,从而指导临床正确评估产后出血量,做到产后出血的早期识别、早期治疗。方法:通过称重法结合目测法测量产时及产后24小时作为产后出血量的临床评估手段,同时以分娩前后血红蛋白的差值作为产后出血量的实验室校正指标,校正产后出血量。并且通过分组对比组间产后出血量的差异性推测影响产后出血量的相关因素,从而指导临床。结果:产妇分娩前血红蛋白为121.24±10.69g/L;显著高于分娩后的血红蛋白浓度107.26±12.25g/L;通过临床评估得到产妇产后出血量约为239.40±89.64ml,通过血红蛋白差值校正的出血量约为559.01±350.47ml,两者差异存在统计学意义;血红蛋白校正值明显高于临床估计值。而通过分组比较可得知初产妇产后出血量显著高于经产妇,第二产程时长较长的产妇产后出血量显著升高;通过血红蛋白校正的产后出血量中合并胎膜早破产妇较无合并症产妇出血量少;而临床评估中合并妊娠期糖尿病较无合并症及合并胎儿窘迫的产妇出血量增多。结论:临床评估产后出血量仍存在一定的误差性,临床评估结合分娩血红蛋白变化能更好的提高评估的准确性。
[Abstract]:Objective: To evaluate the postpartum hemorrhage of vaginal delivery women by hemoglobin correction, so as to guide the correct clinical evaluation of postpartum hemorrhage, early recognition and treatment of postpartum hemorrhage. The difference of postpartum hemoglobin was used as a laboratory correction index to correct postpartum hemorrhage, and the related factors affecting postpartum hemorrhage were predicted by comparing the difference of postpartum hemorrhage between groups. The white concentration was 107.26+12.25 g/L, the amount of postpartum hemorrhage was 239.40+89.64 ml, and the amount of hemoglobin difference corrected was 559.01+350.47 ml. The difference was statistically significant; the hemoglobin corrected value was significantly higher than the clinical estimate. The amount of postpartum hemorrhage in women with prolonged second stage of labor was significantly higher than that in women without premature rupture of membranes. There are still some errors in evaluating the amount of postpartum hemorrhage. Clinical evaluation combined with hemoglobin changes during delivery can improve the accuracy of evaluation.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.461

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