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目的检测产妇凝血功能和D-二聚体,探讨其对产后出血的预测价值。方法选取310例产妇,根据产妇分娩方式分为顺产组和剖宫产组。临产出血量>500 ml诊断为产后出血,产前检测凝血功能和D-二聚体,探讨凝血相关指标与产后出血的关系。结果 310例产妇,正常分娩214例,其中产后出血21例,占9.8%;剖宫产96例,其中产后出血18例,占18.8%。剖宫产产后出血率明显高于顺产,差异有统计学意义(P<0.05)。剖宫产和顺产组产后出血组PT、APTT、INR、D-D均高于正常组,而FIB水平低于正常组;与顺产比较,剖宫产组产后出血患者D-D水平明显更高,差异均有统计学意义(P<0.05)。高龄、FIB、D-D、剖宫产是产后出血的独立危险因素(P<0.05)。结论血清D-D水平对产后出血有较好的预测价值。
Objective To detect maternal coagulation function and D-dimer, and to explore its predictive value for postpartum hemorrhage. Methods 310 cases of maternal women were selected, according to maternal delivery mode is divided into the delivery group and cesarean section group. The amount of labor-induced bleeding> 500 ml was diagnosed as postpartum hemorrhage, prenatal testing of coagulation and D-dimer, and the relationship between coagulation-related indicators and postpartum hemorrhage. Results 310 cases of maternal, 214 cases of normal delivery, of which 21 cases of postpartum hemorrhage, accounting for 9.8%; 96 cases of cesarean section, including postpartum hemorrhage in 18 cases, accounting for 18.8%. The cesarean section postpartum hemorrhage rate was significantly higher than that of the natural delivery, the difference was statistically significant (P <0.05). The levels of PT, APTT, INR, DD in cesarean section and cesarean section postpartum hemorrhage group were higher than those in normal group, while the FIB level was lower than that in normal group. DD was significantly higher in cesarean section group with postpartum hemorrhage Statistical significance (P <0.05). Elderly, FIB, D-D and cesarean section were independent risk factors of postpartum hemorrhage (P <0.05). Conclusion Serum D-D levels have a good predictive value for postpartum hemorrhage.