从部分贫困县住院分娩资料分析 看农村地区围产保健对策  

Strategies on Perinatal Health Cares in Rural Areas : Basing on an Analysis to the Data of Deliveries in Hospitals in Four Poor Counties of China

作　　者：王燕[1] 安琳[1] 高燕秋 

机构地区：[1]北京医科大学妇幼卫生学系,100083

出　　处：《中国初级卫生保健》1999年第1期24-27,共4页Chinese Primary Health Care

基　　金：世界银行提供贷款进行的卫生项目课题之一

摘　　要：利用1996年在四川省和陕西省4个卫—Ⅵ项目县县乡两级医院,采用前瞻性研究方法收集的住院分娩资料,着重分析了产科床位使用率、产科接生工作负荷、产妇住院天数、剖腹产比例。结果显示:产科床位使用率不高,绝大多数医院都有50%以上的产科床位日没有利用;接生工作负荷亦不高,各医院从事接生人员的1周平均接生数在0.5～2.6之间;在一些乡卫生院产妇住院时间短,50%以上的产妇住院不满1天;陕西的两县剖腹产比例偏低。结果提示在贫困农村围产保健工作的对策:(1)重点应放在减少住院分娩的障碍因素、提高产妇对医院产科服务的利用上,而不应盲目增加产科的床位与人力;(2)使医院产科部分人员走出医院,开展围产保健宣教与服务,县级产科人员可从事培训工作,从而使产科人力资源潜力得到更充分发挥;(3)加强村卫生人员产后访视技能的培训,同时对乡级产科人员培训时应注意强调产后密切观察至少2小时再允许产妇出院;(4)在剖腹产比例过低的地区开展围产保健项目时有针对性地开展宣教,消除人们对剖腹产术的不正确认识,同时,通过进修培训提高产科医生对剖腹产指征的掌握及剖腹产技术。Basing on data obtained prospectively on admissions to the midwifery services in County General Hospitals, Maternal and Child Health Stations, Central Township Hospitals and Regular Township Hospitals in four poor counties of Sichuan Province and Shanxi Province, the study analyzed bed occupancy rates, midwifery service load, average days in hospital for delivered mothers and proportion of ce-sarean sections in obstetrical departments of these hospitals. The results showed that these obstetrical departments were not fully utilized. In each studied hospital the obstetric bed occupancy rate did not reach 50% except one county general hospital) the average number of deliveries a week per midwife of doctor was only 0. 5-2. 6. The result also revealed in some township hospitals mothers stayed a few hours in hospitals after delivery. In two counties from Shanxi Province the proportion of cesarean section was relatively low; the proportions of cesarean section ranged from 3% to 9% in three hospitals of county level and there was almost no cesarean section conduction in township hospitals. The results suggest the strategies of perinatal health cares in rural areas as the followings; (1) the further work should focus on increasing the utilization of women for obstetrical services rather than extending obstetric beds or personnel j (2)part of obstetric personnel should go out of the hospitals to provide services of disseminate health care knowledge; (3) postpartum visit skill should be emphasized when training village midwife; (4) in some areas the correct knowledge on the conduction of cesarean section should be given to villagers and cesarean section skill and indication should be trained to obstetric doctors.

关 键 词：分娩 剖腹产 住院 妇幼保健 农村地区 

分 类 号：R714.7[医药卫生—妇产科学] R173[医药卫生—临床医学]