目的：通过对术中出血的原因及相关因素的分析来研究降低第二产程剖宫产率及减少术中出血量的方法。方法选取我科于第二产程行剖宫产术的213例产妇为观察组，选取同期于第一产程行剖宫产术的642例产妇为对照组。收集两组孕产妇的临床资料，统计两组产妇剖宫产术中出血量并分析其原因。结果观察组术中出血量和术中出血发生率均较对照组高，两组组间差异均有统计学意义（P ＜0.05）；观察组剖宫产术中出血原因分别为子宫收缩乏力（47.2%）、子宫切口裂伤（33.3%）、胎盘因素（19.4%）；对照组剖宫产术中出血原因分别为胎盘因素（59.5%）、子宫收缩乏力（27.0%）、子宫切口裂伤（13.5%），两组差异有统计学意义（P ＜0.05）。结论第二产程剖宫产术中出血的主要原因是子宫收缩乏力、子宫切口裂伤。%Objective To analyze the cause and related factors of intraoperative bleeding during cesarean section in the second stage of labor, in order to reduce the labor cesarean section rate and the intraoperative blood loss. Methods 213 cases of pregnant women in the second stage process for cesarean section were selected in our department as the observation group, select the same period in the first production process undergoing cesarean section of 642 cases of pregnant women as the control group. To collect the clinical data of two groups of pregnant women, the two groups of maternal cesarean section bleeding volume and analysis of the reasons. Results Intraoperative blood loss and incidence of intraoperative bleeding of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05). The causes of hemorrhage in cesarean section of the observation group were weakness of uterine contraction (47.2%), uterine incision laceration (33.3%) and placenta factor (19.4%), the causes of hemorrhage in cesarean section of the observation group were placenta factor (59.5%), weakness of uterine contraction (27.0%) and uterine incision laceration (13.5%), and the difference were statistically significant (P<0.05). Conclusion Weakness of uterine contraction and uterine incision laceration are major causes of hemorrhage during cesarean section in the second labor.
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