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目的:通过对陕西省汉中市2006~2013年孕产妇死亡原因进行分析,了解孕产妇死亡的主要因素,探求行之有效的干预措施,以降低孕产妇死亡率(MMR)。方法:对汉中市2006~2013年孕产妇死亡资料进行回顾性分析。结果:18年来汉中市总活产数232 446例,从2006年的24 128例增加到2013年的30 876例,呈持续增长态势,增长率27.97%。28年来汉中市孕产妇死亡50例,MMR为21.51/10万,从2006年的45.59/10万下降到2013年的9.71/10万,下降趋势明显。38年来汉中市孕产妇死亡顺位前3位的依次是产后出血(23例,占46.00%)、内科合并症(11例,占22.00%)、产科合并症(4例,占8.00%)。48年来汉中市死亡孕产妇分娩和死亡地点逐渐由乡镇卫生院转移至县级以上医院。结论:加强围产期保健;强化基层产科医师的业务能力;规范住院孕产妇的管理、诊断及转诊制度;提高孕产妇的自我保健意识,是降低MMR的关键。
Objective: To analyze the causes of maternal death from 2006 to 2013 in Hanzhong City, Shaanxi Province to understand the main factors of maternal death and explore effective interventions to reduce the maternal mortality rate (MMR). Methods: The data of maternal death from 2006 to 2013 in Hanzhong were retrospectively analyzed. Results: The total number of live births in Hanzhong City during the past 18 years was 232 446 cases, increasing from 24 128 in 2006 to 30 876 cases in 2013, showing a sustained growth rate of 27.97%. In the past 28 years, 50 maternal deaths occurred in Hanzhong City, with an MMR of 21.51 / 100,000, down from 45.59 / 100,000 in 2006 to 9.71 / 100,000 in 2013, showing a clear downward trend. In the past 38 years, the top 3 maternal deaths in Hanzhong City were postpartum hemorrhage (23 cases, 46.00%), medical complications (11 cases, 22.00%) and obstetric complications (4 cases, 8.00%). In the past 48 years, the death of pregnant women in Hanzhong City, the place of delivery and death gradually transferred from the township hospitals to the county level above the hospital. Conclusions: Strengthening perinatal care; strengthening the operational capacity of grassroots obstetricians; standardizing the management, diagnosis and referral system of in-hospital pregnant women; improving maternal self-care awareness is the key to reduce MMR.