剖宫产不同胎盘娩出时间对产后出血量的影响
投稿时间:2015-11-12  修订日期:2015-12-21  点此下载全文
引用本文:刘叶,张文亮,王娜,吴珍,赵娜,邢景娜.剖宫产不同胎盘娩出时间对产后出血量的影响[J].医学研究杂志,2016,45(7):56-58
DOI: 10.11969/j.issn.1673-548X.2016.07.016
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作者单位E-mail
刘叶 073000 定州, 河北省第七人民医院产二科 ly1297149349@sina.com 
张文亮 073000 定州, 河北省第七人民医院神经外科  
王娜 073000 定州, 河北省第七人民医院产二科  
吴珍 073000 定州, 河北省第七人民医院产二科  
赵娜 073000 定州, 河北省第七人民医院产一科  
邢景娜 073000 定州, 河北省第七人民医院妇科  
基金项目:河北省医学科学研究重点课题(20150550)
中文摘要:目的 探讨剖宫产两种胎盘娩出时间对产后出血量的影响。方法 200例来笔者医院进行剖宫产分娩产妇分为实验组和对照组组各100例,其中试验组胎儿娩出后延迟5~8min后娩出胎盘,对照组胎儿娩出后即可剥离胎盘,比较2组产术中、产后2h和产后24h出血量,产后72h RBC和Hb水平及术后并发症发生情况。结果 试验组剔除6例,对照组剔除11例胎盘超时娩出的产妇,对比两组剩余产妇的发现实验组术中及产后2h出血量、产后24h出血量及胎盘娩出时间均明显低于对照组(206.32±43.24ml vs 245.24±56.56ml、188.21±83.83ml vs 238.39±109.82ml、265.34±113.83ml vs 324.42±175.52ml),而RBC和Hb水平明显高于对照组[(2.82±0.51)×1012/L vs(2.42±0.48)×1012/L,102.7±9.2g/L vs 94.9±7.4g/L],差异均有统计学意义(P<0.05),两组产妇均未发生宫缩乏力情况,两组胎盘残留,切口愈合异常,产褥感染,术后发热及盆腔疼痛发生率,两组比较差异无统计学意义(P >0.05)。结论 剖宫产手术胎儿娩出后胎盘应当延迟5~8min娩出,以便能降低产后出血量。
中文关键词:剖宫产|产后出血|胎盘娩出|时间
 
Effect of Different Placenta Expulsion Time on the Amount of Caesarean Postpartum Hemorrhage
Abstract:Objective To investigate the effect of two kinds of placenta expulsion time on the amount of caesarean postpartum hemorrhage. Methods In this study, we took 200 parturient cases underwent cesarean section in our hospital as the example. They were divided into the experimental group and the control group, with 100 cases in each group. In the experimental group, the expulsion of placenta was delayed for 5-8 mins after the delivery of baby; in the control group, the placenta was timely peeled after the delivery of baby. We compared the corresponding amount of postpartum hemorrhage during cesarean section, within 2h and 24h postpartum, the levels of RBC and Hb in 72h postpartum, as well as the occurrence of postoperative complications in two groups. Results There were 6 cases and 11 cases excluded from the experimental group and the control group respectively for the timeout in the expulsion of placenta. After comparing the situation of the remaining parturient cases in the two groups, we found that, the corresponding amount of postpartum hemorrhage during caesarean section, within 2h and 24h postpartum, as well as the placenta expulsion time in the experimental group were all significantly lower than the control group(206.32±43.24ml vs 245.24±56.56ml, 188.21±83.83ml vs 238.39±109.82ml,265.34±113.83ml vs 324.42±175.52ml); while the levels of RBC and Hb were significantly higher than the control group[(2.82±0.51)×1012/L vs (2.42±0.48)×1012/L,102.7±9.2g/L vs 94.9±7.4g/L]. The difference between groups was statistically significant (P<0.05). The uterine atony did not occur in two groups. In addition, the incidence rates in the retention of the placenta, abnormal wound healing, puerperal infection, postoperative fever and pelvic pain in two groups had no statistically significant difference (P >0.05). Conclusion In cesarean section, the expulsion of placenta should be delayed 5 to 8 minutes after the delivery of baby, in order to reduce the amount of postpartum hemorrhage.
keywords:Uterine-incision delivery|Postpartum hemorrhage|Placental expulsion|Time
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