摘要
目的探讨产后出血的危险因素以及产后出血预测评分表的应用价值。方法选取2013年1月—2016年12月在我院治疗的产后出血患者126例为观察组,同时选取非产后出血产妇674例作为对照组,调查产妇孕周、产次、分娩方式、胎儿体质量等,比较2组产后出血预测评分,分析产后出血的影响因素,并分析产后出血预测评分对其的诊断价值。结果观察组≥35岁、体质量指数≥24 kg/m^2、流产次数≥2次、产次≥2次、剖宫产、胎儿体质量≥4 000 g和有妊娠并发症比例分别为44.44%、47.62%、40.48%、44.44%、64.29%、43.65%和66.67%,明显高于对照组(P<0.05)。观察组产后出血预测评分高于对照组[(6.83±1.25)分vs.(2.01±0.98)分,t=48.356,P<0.01]。Logistic回归分析结果显示:胎儿体质量≥4 000 g、剖宫产、有妊娠并发症和流产次数≥2次为孕妇产后出血的危险因素(OR分别为4.195、7.553、5.596和7.192,P<0.05)。产后出血预测评分表预测产后出血ROC曲线分析曲线下面积(AUC)为0.657,当总评分≥4分时,预测产后出血的灵敏度为81.25%,特异度为65.55%。结论产后出血与胎儿出生体质量、剖宫产、妊娠并发症、流产次数有关;产后出血预测评分表有望成为临床预测产后出血的有效工具。
Objective To explore the risk factors of postpartum hemorrhage and the application value of predictingscore of postpartum hemorrhage. Methods A total of 126 cases of postpartum hemorrhage hospitalized in our hospital fromJanuary 2013 to December 2016 were included in observation group, and 674 puerperae without postpartum hemorrhagewere used as the control group. Data of the gestational age, delivery time, delivery mode and fetal weight were investigated,and the predictive scores of postpartum hemorrhage were compared between the two groups. Logistic regression analysis wascarried out on influencing factors of postpartum hemorrhage. The value of postpartum hemorrhage prediction score indiagnosing postpartum hemorrhage was evaluated by ROC curve. Results The proportions of patients ≥35 years old,BMI ≥ 24 kg/m^2, the number of abortion ≥ 2 times, production time ≥ 2 times, cesarean section, fetal weight ≥4 000 g andpregnancy rates were 44.44%, 47.62%, 40.48%, 44.44%, 64.29%, 43.65% and 66.67% in observation group, which weresignificantly higher than those of control group(P<0.05). The predictive score of postpartum hemorrhage was higher inobservation group than that in control group[(6.83 ± 1.25) points vs.(2.01 ± 0.98) points, t=48.356, P<0.01]. Logisticregression analysis showed that the fetal weight ≥ 4 000 g, cesarean section, patients with pregnancy complications andabortion ≥ 2 times were risk factors of postpartum hemorrhage(OR=4.195, 7.553, 5.596 and 7.192, P<0.05). Prediction ofpostpartum hemorrhage ROC curve AUC was 0.657 evaluated by postpartum prediction scale, and when the total score ≥4 points, the sensitivity of predicting postpartum hemorrhage was 81.25%, specificity was 65.55%. Conclusion Postpartumhemorrhage is related to fetal birth weight, cesarean section, pregnancy complications and the number of abortions. Thepredictive score of postpartum hemorrhage is expected to be an effective tool for predicting postpartum hemorrhage inclinical practice.
出处
《天津医药》
CAS
2017年第10期1064-1067,共4页
Tianjin Medical Journal
