使用“产科休克指数”作为辅助手段识别大量产后出血患者的显著失血。
Use of the "obstetric shock index" as an adjunct in identifying significant blood loss in patients with massive postpartum hemorrhage.
机构信息
Department of Obstetrics and Gynaecology, St George's Healthcare NHS Trust, London, UK.
Department of Obstetrics and Gynaecology, St George's Healthcare NHS Trust, London, UK.
出版信息
Int J Gynaecol Obstet. 2014 Mar;124(3):253-5. doi: 10.1016/j.ijgo.2013.08.020. Epub 2013 Dec 4.
OBJECTIVE
To establish the normal range for the "obstetric shock index" (OSI) after birth and to determine its usefulness as an aid to estimate blood loss in postpartum hemorrhage (PPH).
METHODS
A retrospective case-control analysis was conducted involving pregnant women admitted to St Georges Hospital for delivery: 50 with no PPH (control group) and 50 with massive PPH (>30% loss of blood volume; case group). The OSI was calculated at 10 and 30 minutes from PPH onset.
RESULTS
Mean OSI in the control group at 10 and 30 minutes was 0.74 (range, 0.4-1.1) and 0.76 (range, 0.5-1.1), respectively. In the case group, mean OSI at 10 and 30 minutes was 0.91 (range, 0.4-1.5) and 0.90 (range, 0.5-1.4), respectively, with 64% requiring blood products. In the case group, 89% of women with an OSI of 1.1 or more at 10 minutes required transfusion; 75% with an OSI of 1.1 or more at 30 minutes required transfusion.
CONCLUSION
We recommend that the normal OSI range should be 0.7-0.9. An OSI of more than 1 seems to be a useful adjunct in estimating blood loss in cases of massive PPH and in predicting the need for blood and blood products.
目的
建立产后“产科休克指数”（OSI）的正常范围，并确定其作为估计产后出血（PPH）中失血量的辅助手段的有用性。
方法
对圣乔治医院分娩的孕妇进行回顾性病例对照分析：50 例无 PPH（对照组）和 50 例大量 PPH（>30%失血量；病例组）。在 PPH 发生后 10 分钟和 30 分钟计算 OSI。
结果
对照组在 10 分钟和 30 分钟时的平均 OSI 分别为 0.74（范围，0.4-1.1）和 0.76（范围，0.5-1.1）。在病例组中，10 分钟和 30 分钟时的平均 OSI 分别为 0.91（范围，0.4-1.5）和 0.90（范围，0.5-1.4），其中 64%需要输血。在病例组中，89%的 OSI 在 10 分钟时为 1.1 或更高的患者需要输血；75%的 OSI 在 30 分钟时为 1.1 或更高的患者需要输血。
结论
我们建议正常 OSI 范围应为 0.7-0.9。OSI 大于 1 似乎在估计大量 PPH 中的失血量和预测输血和血制品的需求方面是有用的辅助手段。
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