Obstetrics blood transfusion treatment cause and effect evaluation and nursing
产科输血治疗原因及疗效评估与护理

摘要

目的 对产科输血治疗的原因及治疗效果进行分析。方法 研究开展时间为2019年5月-2020年6月，研究期间选取在我院产科接受输血的患者共计70例作为主要研究对象。收集所有患者的临床资料并进行回顾性分析；使用SPSS23.0统计学分析软件对患者的基础资料进行分析，除了年龄、性别等信息外，还包括出血因素、输血种类和剂量、临床治疗效果等。另外对患者进行相应的护理，首先进行护理评估及健康教育，其实采用正确的方法采集标准和输血前检查，在进行输血时护理人员要严格按照相关规定进行操作。结果 经过研究可知，宫缩乏力、瘢痕子宫、产前贫血、血小板减少症、前置胎盘、宫颈损伤等是导致产科输血的主要原因，其所占比例依次是34.29%（24/70）、22.86%（16/70）、17.14%（12/70）、11.43%（8/70）、8.57%（6/70）、5.71%（4/70）。其中引起出血量最少的因素是签字胎盘。前置胎盘导致出血的患者中经过产科术后联合输血治疗的3例患者疗效较差，为了避免对患者造成影响，故使用子宫次全切除术；胎盘前置导致出血的患者与其他类型相比，子宫次切除率较高，差异有统计学意义（P＜0.05）；产前输血的方法主要应用于产前贫血和血小板减少症的患者中。经过治疗后所有的患者均以好转或治愈出院，但有6例患者出现胎死宫内或子宫次切全切除的情况。此外，比较顺产输血和剖宫产输血，顺产输血的患者共有17例相对于剖宫产输血患者42例较少，存在差异有统计学意义（P＜0.05），同时3.81U、704.54mL、10.21U、1治疗量分别是剖宫产患者的红细胞、血浆、冷沉淀、血小板输注量，而3.5U、691.66mL、9.68U、为输血小板则为顺产患者的输注情况，其中顺产组和剖宫产组出来血小板输注比例外，其他比例相差不大。结论 为了保证患者的生命安全，产科临床中应该对产科输血的因素进行详细的分析，并根据分析结果进行针对性治疗，并加强各方面的管理，只有这样才能够减少不良预后情况的发生。

Abstract

Objective: To analyze the causes and therapeutic effects of obstetric blood transfusion.
Methods: The study was carried out from May 2019 to June 2020. During the study period, a total of 70 patients who received blood transfusion in the obstetrics department of our hospital were selected as the main research objects. Collect clinical data of all patients and conduct retrospective analysis; use SPSS23.0 statistical analysis software to analyze the basic data of patients. In addition to information such as age and gender, it also includes bleeding factors, type and dose of blood transfusion, clinical treatment effects, etc. . In addition, the patients should be given corresponding nursing care. First, carry out nursing assessment and health education. In fact, the correct methods of collection standards and pre-transfusion examinations are adopted. When performing blood transfusions, nursing staff should strictly follow relevant regulations.
Results: After research, it can be seen that the main causes of obstetric blood transfusion are asthenia, scarring of the uterus, prenatal anemia, thrombocytopenia, placenta previa, and cervical injury, and their proportions are 34.29% (24/70), 22.86% (16/70), 17.14% (12/70), 11.43% (8/70), 8.57% (6/70), 5.71% (4/70). The least bleeding factor is the placenta signature. Among the patients with hemorrhage caused by placenta previa, 3 patients who underwent combined blood transfusion after obstetric surgery had poor curative effect. In order to avoid affecting the patients, subtotal hysterectomy was used; patients with hemorrhage caused by placenta previa were compared with other types , The rate of hysterectomy is higher, and the difference is statistically significant (P<0.05); the method of prenatal blood transfusion is mainly used in patients with prenatal anemia and thrombocytopenia. After treatment, all patients were cured or discharged. However, 6 patients experienced intrauterine fetal death or subtotal hysterectomy. In addition, comparing normal delivery blood transfusion and cesarean section blood transfusion, there are 17 cases of normal delivery blood transfusion patients compared with 42 cases of cesarean section blood transfusion patients, the difference is statistically significant (P<0.05), and 3.81U, 704.54mL, 10.21 U and 1 therapeutic doses are the red blood cell, plasma, cryoprecipitate, and platelet transfusion volume of cesarean section patients, while 3.5 U, 691.66 mL, 9.68 U, and platelet transfusion refer to the transfusion of normal delivery patients. Among them, the normal delivery group and Except for the platelet transfusion ratio in the cesarean section group, the other ratios were not much different.
Conclusion  : In order to ensure the life safety of patients, the obstetrical clinic should conduct detailed analysis of the factors of obstetric blood transfusion, and carry out targeted treatment based on the analysis results, and strengthen management in all aspects, only in this way can the occurrence of poor prognosis can be reduced.