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目的了解分析2006-2014年红河州孕产妇死亡原因和变化趋势,为降低孕产妇死亡率提供有效的干预措施。方法按照《云南省孕产妇死亡监测方案》的要求进行监测,按照世界卫生组织“十二格表法”进行评审分析,收集整理2006-2014年红河州孕产妇死亡监测及评审资料进行统计分析。结果 2006年与2014年相比红河州孕产妇死亡率下降了48.85个十万分点;2006-2014年间红河州孕产妇死因中直接产科原因仍占首位,间接产科死因中内科合并症有所上升;在直接产科死因中产科出血仍是全州孕产妇死亡的首要因素,近几年随着经产妇和瘢痕子宫再次妊娠人数增多,加之计划外怀孕不规范终止妊娠等问题导致产科出血死因居高不下。评审影响可避免死亡的“三个延误”中:医疗处理延误是导致红河州孕产妇死亡的首要影响因素,主要表现为医疗保健系统的知识技能不足及内部管理不到位等问题。结论依托国家农村孕产妇住院分娩补助、新农合、国家基本公共卫生服务等项目,建立有效的孕产妇健康管理机制,将高危孕产妇的筛查、评分、管理作为工作重点;各医疗保健机构应与时俱进,加强医疗质量及内部管理,强化人员培训,重点关注产科的建设和发展,提高产科服务能力。
Objective To understand the causes and trends of maternal mortality in Honghe Prefecture from 2006 to 2014 so as to provide effective interventions to reduce the maternal mortality rate. Methods According to the requirements of “maternal mortality monitoring program in Yunnan Province”, the evaluation was conducted according to the WHO “Twelve Tables” and statistics of maternal deaths monitoring and assessment in Honghe Prefecture from 2006 to 2014 were collected analysis. Results Compared with 2014, the maternal mortality rate in Honghe Prefecture decreased by 48.85 in 2006; the direct maternity cause among the causes of maternal death still took the first place in Honghe Prefecture from 2006 to 2014, and the medical comorbidity in indirect obstetric causes increased ; Obstetric bleeding in direct obstetric causes of obstetrics and gynecology bleeding remains the most important factor in the state maternal death in recent years with the increase in the number of pregnant women and scarring uterus again, combined with unplanned pregnancy non-standard termination of pregnancy and other issues leading to high deaths of obstetric hemorrhage No less Among the “three delays” in assessing avoidable deaths, the delay in medical treatment was the primary factor that led to the maternal death in Honghe Prefecture, mainly due to inadequate knowledge and skills of the health care system and inadequate internal management. Conclusions Relying on such items as hospital delivery assistance for rural pregnant women, NCMS and basic public health services, we set up an effective maternal health management mechanism and put the screening, scoring and management of high-risk pregnant women as the focus of work. Each health care institution Should advance with the times, strengthen the medical quality and internal management, strengthen personnel training, with a focus on the obstetrics construction and development, and improve obstetric services.