【摘要】 目的　探讨重度产后出血的相关病因及防治措施。方法　对我院 1997- 0 1～ 2 0 0 3- 12分娩的 86例重度产后出血进行回顾性分析。结果　重度产后出血的发生率为 0 39% ,83 7%发生在产后 2h内。剖宫产重度产后出血的发生率与阴道分娩相比 ,差异有非常显著性 (P =0 0 0 0 ) ,引起重度产后出血的相关病因依次是 :胎盘因素 (4 4 2 % )、子宫收缩乏力 (33 7% )、子宫下段切口因素 (8 1% ) ,DIC(5 8% )、软产道损伤(5 8% ) ,以及子宫破裂 (2 3% )。结论　胎盘因素是引起重度产后出血的主要病因。防治措施关键在于加强妇女生育保健措施 ,严格掌握剖宫产手术指征更多还原

【Abstract】 Objective To investigate correlative factors and measures of prevention and treatment of severe postpartum hemorrhage (PPH). Methods The study consisted of 86 cases women who developed sever PPH after vaginal delivery and cesarean section over the 7 years from January 1997 to December 2003. Severe PPH was defined as blood loss greater than 1000ml or with shock. These 86 cases of severe PPH were retrospectively analyzed for clinical parameters and management. Results The incidence of severe PPH was 0.39% 83.7% of cases occurred between delivery and 2 h after child birth. The incidence that cesarean section occurred severe PPH was 0.63% which was significantly higher than vaginal delivery. The etiological factors of severe PPH were placental factor (44.2%), uterine factor (33.7%), incision factor of lower uterine segment (9.3%), DIC (5.8%) soft tissue injury of birth canal (5.8%) and uterine rupture (2.3%). Conclusion The severe PPH might be mostly attributed to placenta factor. Effects to reduce the incidence of severe PPH should not only be directed at proper management of labor but also strengthen maternal reproductive health care and master the indication of cesarean section strictly.更多还原