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目的研究探讨剖宫产不同胎盘娩出时间对产妇凝血功能、纤维蛋白溶解(纤溶)指标的影响。方法 146例行剖宫产产妇,按照胎盘娩出时间的不同分为观察组与对照组,各73例。观察组产妇待胎儿娩出5 min后娩出胎盘,对照组产妇待胎儿娩出后立即剥离胎盘,对比两组产妇的胎盘娩出时间、出血量、凝血功能及纤溶指标。结果观察组产妇的胎盘娩出时间显著短于对照组,差异有统计学意义(P<0.05);观察组产妇的术中出血量、产后2 h、24 h出血量显著少于对照组,差异有统计学意义(P<0.05);观察组产妇的凝血功能、纤溶指标均显著优于对照组(P<0.05)。观察组患者下床活动时间(2.16±0.86)d、住院治疗时间(6.28±1.94)d短于对照组患者的(4.62±1.19)d、(12.05±2.03)d,,差异均具有统计学意义(P<0.05)。结论在胎儿娩出5 min后剥离胎盘,能够改善产妇的凝血功能与纤溶指标,减少产后出血量。
Objective To study the effect of different cesarean delivery time on maternal coagulation and fibrinolysis. Methods 146 cases of cesarean section were divided into observation group and control group according to the different time of delivery of placenta, each of 73 cases. The observation group maternal fetus was delivered 5 minutes after the placenta was delivered, the control group maternal fetus immediately after delivery was stripped of the placenta, compared with the two groups of maternal placenta delivery time, blood loss, coagulation and fibrinolysis. Results The maternal placenta delivery time in the observation group was significantly shorter than that in the control group (P <0.05). The intraoperative blood loss in the observation group was significantly less than that in the control group at 2 h and 24 h postpartum Statistical significance (P <0.05). The coagulation function and fibrinolytic index in the observation group were significantly better than those in the control group (P <0.05). The difference between the observation group and the control group was (2.16 ± 0.86) d, (6.28 ± 1.94) d and (4.62 ± 1.19) days and (12.05 ± 2.03) days, respectively, and the differences were statistically significant (P <0.05). Conclusion The release of the placenta 5 min after the fetus is delivered can improve the coagulation function and fibrinolysis of the pregnant women and reduce the amount of postpartum hemorrhage.