天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (10): 1064-1067.doi: 10.11958/20170640

• 临床研究 • 上一篇    下一篇

产后出血危险因素分析以及产后出血 预测评分表的应用价值

张丹，孙丽，赵晶晶   

  1. 辽宁电力中心医院妇产科（邮编 110004）
  • 收稿日期:2017-06-05 修回日期:2017-07-21 出版日期:2017-10-15 发布日期:2017-10-13
  • 通讯作者: 张丹 E-mail:hero731206@163.com
  • 作者简介:张丹（1973），女，副主任医师，本科，主要从事妇产科临床研究

Analysis of risk factors of postpartum hemorrhage and application value of predictive score of postpartum hemorrhage

ZHANG Dan, SUN Li, ZHAO Jing-jing   

  1. Department of Obstetrics and Gynecology, Liaoning Electeric Power Center Hospital, Liaoning 110004, China
  • Received:2017-06-05 Revised:2017-07-21 Published:2017-10-15 Online:2017-10-13

PDF (PC)

3793

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/m2、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。

关键词: 产后出血, 危险因素, Logistic 模型, ROC 曲线, 产后出血预测评分表

Abstract: Objective To explore the risk factors of postpartum hemorrhage and the application value of predicting score of postpartum hemorrhage. Methods A total of 126 cases of postpartum hemorrhage hospitalized in our hospital from January 2013 to December 2016 were included in observation group, and 674 puerperae without postpartum hemorrhage were 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 was carried out on influencing factors of postpartum hemorrhage. The value of postpartum hemorrhage prediction score in diagnosing postpartum hemorrhage was evaluated by ROC curve. Results The proportions of patients ≥35 years old, BMI ≥ 24 kg/m2, the number of abortion ≥ 2 times, production time ≥ 2 times, cesarean section, fetal weight ≥4 000 g and pregnancy rates were 44.44%, 47.62%, 40.48%, 44.44%, 64.29%, 43.65% and 66.67% in observation group, which were significantly higher than those of control group (P＜0.05). The predictive score of postpartum hemorrhage was higher in observation group than that in control group［(6.83 ± 1.25) points vs. (2.01 ± 0.98) points, t=48.356, P＜0.01]. Logistic regression analysis showed that the fetal weight ≥ 4 000 g, cesarean section, patients with pregnancy complications and abortion ≥ 2 times were risk factors of postpartum hemorrhage (OR=4.195, 7.553, 5.596 and 7.192, P＜0.05). Prediction of postpartum 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 Postpartum hemorrhage is related to fetal birth weight, cesarean section, pregnancy complications and the number of abortions. The predictive score of postpartum hemorrhage is expected to be an effective tool for predicting postpartum hemorrhage in clinical practice.

Key words: postpartum hemorrhage, risk factors, Logistic models, ROC curve, postpartum hemorrhage prediction score table

中图分类号: