农村地区产后出血防治模式探讨  

Exploring prevention and treatment model of postpartum hemorrhage in rural area

作　　者：宋波[1] 李丽娟[1] 吴久玲[1] 苏穗青[1] 

机构地区：[1]中国疾病预防控制中心妇幼保健中心,北京100089

出　　处：《中国妇幼健康研究》2013年第3期310-312,350,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的探索农村地区有效、适宜的产后出血防治模式。方法采用前瞻性研究方法，对医疗机构实施管理及技术层面综合干预，比较其干预前后产后出血防治各项指标变化，评价综合防治效果。结果建立了产后出血防治模式，完善了产后出血防治的相关管理机制，统一制定了产后出血系列管理制度；医务人员对产后出血高危因素的筛查能力得到提高，产后出血高危因素检出率由基调时的7．94％，上升至研究实施期间的39．57％（χ^2=147．34，P〈0．001）；医务人员对产后出血的早期识别能力增强，产后出血报告率由0．39％提高为1．17％（χ^2=19．37，P〈0．001）；产后出血防治适宜技术应用比例增加；医务人员对产后出血救治能力提高，死于产后出血的孕产妇比例由基调时的36．67％下降为研究实施期间的9．09％，未发现有统计学差异（P=0．128）。结论建立以加强农村地区产后出血防治管理与技术服务为重点的综合防治模式，对防治产后出血行之有效，可操作性强．Objective To explore an effective and suitable prevention and treatment model for postpartum hemorrhage （PPH） in rural areas. Methods A prospective study method was adopted. Comprehensive intervention measures on management and technical service were implemented in target hospitals. The comparison of the changes on related indicators of PPH prevention and treatment before and during the intervention was made so as to evaluate the effect of the relevant prevention and treatment model. Results The prevention and treatment model of PPH was established, and the management system of prevention and treatment for PPH was developed and improved. The screening ability of the grassroots staff for PPH risk factors was improved, and the detection rate of PPH risk factor increased from 7.94% in baseline survey to 39.57% during the implementation of research （χ^2= 147.34, P 〈 O. 001 ）. The early recognition ability of grassroots staff for PPH was enhanced, and PPH reporting rate increased from 0.39% to 1.17% （χ^2= 19.37, P 〈 0. 001 ）. The application rate of the appropriate treatment technology for PPH increased, and the treatment ability of grassroots staff for PPH was improved. The maternal mortality due to PPH declined from 36.67% in the baseline survey to 9.09% during the implementation of research, and the difference was not significant （P = 0. 128 ）. Conclusion It is effective and suitable to establish a comprehensive prevention and treatment model of PPH focusing on the enhancement of management and technical service for the prevention and treatment of PPH in rural area.

关 键 词：农村 产后出血 防治 模式 

分 类 号：R714.461[医药卫生—妇产科学]