CAJ | 학술논문

目的：探讨经阴道分娩的孕产妇发生产后出血的危险因素，为产前干预提供依据。方法从我院2011年1月至2013年6月经阴道分娩的产妇中选取220例产后出血的病例作为研究对象，采取病例对照的研究方法，按1：1的比例从同时期自然分娩且无任何异常的产妇中匹配220例作为对照。通过电子病历和自行设计的调查问卷收集研究对象的相关数据；利用单因素 Logistic 回归初步筛选危险因素，利用多因素 logistic 回归结合专业知识确定危险因素。结果经阴道分娩的孕产妇发生产后出血的危险因素包括产妇的既往流产次数(OR =1.269)、产次(OR =1.231)、第二产程时间延长(OR=1.521)、巨大儿(OR=1.497)，而产检(OR=0.780)为产后出血发生的保护因素。结论为降低产后出血的发生率，应基于产后出血的影响因素采取有针对性的预防措施。
목적：탐토경음도분면적잉산부발생산후출혈적위험인소，위산전간예제공의거。방법종아원2011년1월지2013년6월경음도분면적산부중선취220례산후출혈적병례작위연구대상，채취병례대조적연구방법，안1：1적비례종동시기자연분면차무임하이상적산부중필배220례작위대조。통과전자병력화자행설계적조사문권수집연구대상적상관수거；이용단인소 Logistic 회귀초보사선위험인소，이용다인소 logistic 회귀결합전업지식학정위험인소。결과경음도분면적잉산부발생산후출혈적위험인소포괄산부적기왕유산차수(OR =1.269)、산차(OR =1.231)、제이산정시간연장(OR=1.521)、거대인(OR=1.497)，이산검(OR=0.780)위산후출혈발생적보호인소。결론위강저산후출혈적발생솔，응기우산후출혈적영향인소채취유침대성적예방조시。
Objective To investigate the risk factors of postpartum hemorrhage among vaginal deliveries and provide evi-dence for decision-making regarding preventive measures. Methods We adopted a case-control design and 220 postpartum hemorrhage cases were recruited from pregnant women with vaginal delivery and another 220 controls were matched to the cases in terms of delivery date and residency status. Electronic medical records, self-designed questionnaire and Hamilton Anxiety Rating Scale were used to collect data from all subjects. Single and multivariate conditional logistic regressions were used to identify risk factors of postpartum hemorrhage. Results The main risk factors with statistic significance included the times of abortion (OR=1. 269) and delivery (OR=1. 231), prolonged second stage of labor (OR=1. 521) and macrosomia (OR=1. 497). Antepartum care (OR= 0. 780) effectively reduced the postpartum hemorrhage. Conclusion Specially designed measures based on those risk factors shall be taken to prevent the postpartum hemorrhage.