急诊产科输血相关因素分析.docx

急诊产科输血相关因素分析[摘要]目的：分析急诊产科输血原因及其相关因素。探讨如何降低和减少急诊产科输血的措施。方法：对我院2009年1月～2010年9月住院分娩并行急诊输血的20例产妇分娩相关资料进行回顾分析评价各相关因素与产科输血的关系。结果：急诊产科输血率为0.55%输血原因主要为严重的产后出血及分娩前合并重度贫血；严重产后出血为多种高危因素共同作用所致按其引起出血的主要因素分别为宫缩乏力、胎盘因素、产道裂伤、医源性产后观察不严密等；产后出血≥2000ml阴道分娩（77.8%7/9）明显高于剖宫产分娩（27.3%3/11）两者比较差异有统计学意义（P＜0.01）。阴道分娩所致的产后出血原因中除宫缩乏力和胎盘因素外产道裂伤与医源性产后观察不严密亦为其独立危险因素。结论：加强分娩前后特别是阴道分娩前后高危孕产妇产后出血的规范防治积极治疗围生期中、重度贫血有助于降低和减少产科急诊输血。[关键词]产科输血；相关因素；产后出血[中图分类号]R457.1[文献标识码]Ａ[文章编号]1673-7210（2011）03（b）-036-03ThecorrelationfactoranalysisofemergentobstetricalbloodtransfusionWANFenWUShiyuanKANGZhaohaiXIONGYubingDepartmentofGynaecologyandObstetricstheMaternalandChildHealthHospitalofYueyangCityYueyang414000China[Abstract]Objective:Todiscussthecausesandrelatedfactorsofemergentobstetricalbloodtransfusionandprobethemeasurestoreduceanddecreaseemergentobstetricalbloodtransfusion.Methods:Retrospectivelyanalyzedthedeliverydataof20caseswhodeliveredandemergentbloodtransfusedinourhospitalduringJanuary2009toSeptember2010estimatetherelationshipbetweeneachrelatedfactorandemergentobstetricalbloodtransfusion.Results:Therateofemergentobstetricalbloodtransfusionwas0.55%themaincauseswereseverepostpartumhemorrhageandpre-deliverycomplicatedsevereanemia.Severepostpartumhemorrhagewascausedbytheinteractionofmultihighriskfactorsthemainfactorsareinloworderofeffects:uterineinertiaplacentareasonparturientcanallacerationmedicalimprecisepostpartumobservationetc.Vaginaldeliverypostpartumhemorrhagev≥2000ml(77.8%7/9)wasobviouslyhigherthanthatofcesareansection(27.3%3/11)thedifferencewassignificant(P＜0.01).Parturientcanallacerationandmedicalimprecisepostpartumobservationwerealsoindependentriskfactorsinvaginaldeliverypostpartumhemorrhagebesidesuterineinertiaandplacentareason.Conclusion:Enhancementofthen