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中华妇幼临床医学杂志(电子版) ›› 2008, Vol. 04 ›› Issue (06) : 540 -544. doi: 10.3877/cma.j.issn.1673-5250.2008.06.107

论著

称重法精确测量剖宫产术中、至术后出血量的前瞻性多中心临床研究
徐爱群, 曾蔚越, 周远洋, 廖华, 杨霄   
  1. 青岛大学医学院附属烟台毓璜顶医院妇产科(烟台,26400)
    四川大学华西第二医院妇产科
  • 出版日期:2008-12-01

Clinical Measurement of Blood Loss by Weighing Method During and After the Cesarean Section: A Multi-Center, Perspective Trial

Ai-qun XU, Wei-yue ZENG, Yuan-yang ZHOU, Hua LIAO, Xiao YANG   

  1. Department of Obstetrics and Gynecology, the Yuhuangding Hospital Affiliated Qingdao University, Yantai 264000, China
  • Published:2008-12-01
  • Supported by:
    * Project No. 05H072, supported by Sichuan University
引用本文:

徐爱群, 曾蔚越, 周远洋, 廖华, 杨霄. 称重法精确测量剖宫产术中、至术后出血量的前瞻性多中心临床研究[J/OL]. 中华妇幼临床医学杂志(电子版), 2008, 04(06): 540-544.

Ai-qun XU, Wei-yue ZENG, Yuan-yang ZHOU, Hua LIAO, Xiao YANG. Clinical Measurement of Blood Loss by Weighing Method During and After the Cesarean Section: A Multi-Center, Perspective Trial[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2008, 04(06): 540-544.

目的

探讨接受子宫下段剖宫产术产妇术中、至术后精确出血量的测量。

方法

采用多中心、前瞻性研究方法对2005年9月至2006年5月在四川省7所医院接受子宫下段剖宫产,且未合并明显增加出血疾病的产妇共计339例,采取称重法精确测量术中、至术后24 h出血量。

结果

①剖宫产术中出血量为(285. 89±141. 47)mL,至术后2 h总出血量为(334. 68± 159. 78)mL,至术后24 h总出血量为(406. 78±177. 97)mL。剖宫产后出血发生率为24. 48%(83/339)。②产次≥2次者,术中出血量、至术后2 h总出血量及至术后24 h总出血量均高于初产妇(P<0. 05)。③疤痕子宫组(n=21)术中出血量、至术后2 h总出血量及至术后24 h总出血量均高于非疤痕子宫组(n=318)(P<0. 05)。④单持麻醉组(n=286)术后(2~24)h出血量及24 h内总出血量高于双持麻醉组(n=52)(P>0. 05)。

结论

子宫下段剖宫产术中、至术后出血量波动范围较大;经产妇、疤痕子宫和麻醉方式等,均是影响剖宫产出血量的因素。临床应采用称重法精确测定剖宫产出血量。

Objective

To explore the acute blood loss during and after the cesarean section.

Methods

A multi-center, perspective study was carried out on 339 cases of cesarean section without bleeding-associated complications in seven hospitals in Sichuan province from September 2005 to May 2006. The amount of blood loss during and after operation in 24 hours were measured by weighing method.

Results

①The amount of blood loss during operation was(285. 89 ± 141. 47)mL, and the total amount after 2 hours and 24 hours were(334. 68±159. 78)mL,(406. 78±177. 97)mL, respectively. The incidence of postpartum hemorrhage was 24. 48%(83/339).②The blood loss during operation, as well as the cumulative blood loss in 24 hours after operation with pregnant women para 2 or greater were higher than primiparas(P<0. 05).③The blood loss during operation, as well as the cumulative blood loss in 24 hours after operation with scarred uterus(n= 21)were higher than those with non-scarred uterus (n= 318)(P<0. 05).④The blood loss in 2 to 24 hours after operation, as well as the cumulative blood loss in 24 hours with single-injection epidural anesthesia(n=286)were higher than those with double-injection epidural anesthesia(n= 52)(P>0. 05).

Conclusion

The blood loss during and after cesarean section fluctuates with wide range. Some factors such as multiparas, cicatricial uterus and types of anesthesia could influence the blood loss in cesarean section. Weighing method should be used in clinical practice to measure the amount of blood loss during the cesarean section.

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