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目的:分析剖宫产术后24h内的失血量及出血原因,探讨剖宫产术产后出血的诊断标准。方法:回顾分析我院五年来的剖宫产术和阴道分娩,出血量测量方法为容积法+称重法。结果:剖宫产术产后出血量中位数为560ml,明显高于阴道分娩者的415ml(P<0.01)。若以产后出血量≥500ml为标准,出血率为56.2%,而若以产后出血量≥700ml作为标准,其产后出血率为21.1%,与阴道分娩的产后出血率22.1%无差异。结论:(1)剖宫产率的增加,并不降低围产儿死亡率,相反,并发症增多。(2)剖宫产术本身是产后出血的原因。(3)剖宫产术产后出血量的判断标准以≥700ml为宜。(4)为保障母婴健康,应提倡阴道分娩,切实降低剖宫产率。
Objective: To analyze the blood loss and causes of bleeding within 24h after cesarean section, and to explore the diagnostic criteria of postpartum hemorrhage in cesarean section. Methods: Retrospective analysis of five years in our hospital cesarean section and vaginal delivery, bleeding volume measurement method for the volume method + weighing method. Results: The median postpartum hemorrhage of cesarean section was 560ml, which was significantly higher than 415ml of vaginal delivery (P <0.01). If the postpartum hemorrhage ≥ 500ml as the standard, the bleeding rate was 56.2%, and if the postpartum hemorrhage ≥ 700ml as the standard, the rate of postpartum hemorrhage was 21.1%, and vaginal delivery postpartum hemorrhage rate of 22.1% no difference. Conclusion: (1) The increase of cesarean section rate does not reduce the perinatal mortality rate, on the contrary, the complication increased. (2) cesarean section itself is the cause of postpartum hemorrhage. (3) cesarean section postpartum hemorrhage judgment criteria ≥ 700ml is appropriate. (4) To protect the health of mothers and babies, vaginal delivery should be advocated to effectively reduce the cesarean section rate.