农村严重妊娠高血压疾病医疗状况分析  

Prevalence of severe hypertensive disorder complicating pregnancy and current status of medical service in rural areas

作　　者：张凤霞[1] 王临虹[2] 吴久玲[2] 林晓宁[3] 张海燕[3] 冯胜梅 马西 闫淑兰 

机构地区：[1]北京市海淀区妇幼保健院,北京100080 [2]中国疾病预防控制中心妇幼保健中心,北京100013 [3]重庆市妇幼保健院,重庆400010 [4]重庆市长寿县妇幼保健院,重庆长寿401220 [5]陕西省妇幼保健院,陕西西安711500 [6]陕西省镇安县妇幼保健院,陕西镇安710003

出　　处：《中国妇幼健康研究》2007年第3期210-213,共4页Chinese Journal of Woman and Child Health Research

基　　金：WHO资助项目(WP/2006CHN/MPS/2.3/001)

摘　　要：目的了解基层农村地区严重妊娠高血压疾病的发生及医疗服务现状。方法在我国孕产妇死亡率较高的西部农村地区(陕西省和重庆市)选择2个项目县,采用整群抽样的方法,采用依据严重产科并发症审评框架设计的调查问卷对研究点所有提供助产技术服务的医疗机构的全部严重妊娠高血压疾病的发生及医疗服务状况进行临床审评。结果研究地区严重妊娠高血压疾病的发生率为6.15‰(91例),其中重度子痫前期及子痫的发生率分别为4.53‰、1.62‰。严重妊娠高血压疾病与孕产妇死亡之比为91:1。在严重妊娠高血压疾病治疗方面属于规范、基本规范、不规范治疗的比例分别为17.58%、34.07%、48.35%。结论通过对病例的整个保健及诊疗过程进行临床审评,发现基层医疗单位对严重妊娠高血压疾病的医疗救治和管理还存在明显不足,应该加强对他们的培训。Objective To understand prevalence of severe hypertensive disorder complicating pregnancy and its current status of medical service in rural hospitals. Methods In cluster sampling, all cases of severe hypertensive disorder complicating pregnancy and current status of medical service in medical institutions which could offer obstetric technique services of 2 MCH project counties in west China （Shaanxi province and Chongqing city）, where the maternal mortality rate was high, were clinically audited through a questionnaire designed based on Framework of Severe Obstetric Complication Audit. Results The hospital-based prevalence of severe hypertensive disorder complicating pregnancy was 6.15‰, of which, the incidence of severe pre-eclampsia and eclampsia was 4.53‰ and 1.62‰ respectively. The ratio of severe maternal morbidity over maternal mortality was 91 ： 1. Overally, 17. 58% of the patients with severe hypertensive disorder complicating pregnancy received standard treatment, 48.35 % received comparatively standard treatment and 34.07 % received substandard treatment. Conclusion It is found that there are many problems in treatment and management of hypertensive disorder complicating pregnancy in local hospitals through cases clinical audit. Therefore, it is necessary to perform training program for the local health providers.

关 键 词：子痫前期 子痫 严重产科并发症 孕产妇死亡 

分 类 号：R714.24[医药卫生—妇产科学]