贵阳市农村地区产科出血综合防治干预项目的效果评价  

Effectiveness evaluation of comprehensive prevention and control intervention project of obstetric hemorrhage in rural area of Guiyang City

作　　者：郑丹[1] 王开会 周翠萍[1] 刘菁[1] 黎梅[1] 杨倩 孙袁[1] ZHENG Dan;WANG Kai-Hui;ZHOU Cui-Ping(Guiyang Municipal Maternal and Child Health Care Hospital,Guiyang,Guizhou 550003,China)

机构地区：[1]贵阳市妇幼保健院,贵州贵阳550003 [2]风岚县中医院,贵州贵阳564211 [3]贵阳市护理职业学院,贵州贵阳550081

出　　处：《中国妇幼保健》2018年第24期5673-5675,共3页Maternal and Child Health Care of China

基　　金：贵州省科技计划(黔科合LIY字[2014] 30)

摘　　要：目的评价贵阳市农村地区产科出血综合防治干预项目的效果,为我国产科出血综合防治建设提供参考依据。方法采用前瞻性研究方法,在贵阳市农村地区75所助产机构开展产科出血综合防治干预项目,运用卡方检验对比干预前后各项指标。结果干预后产科出血高危因素检出率、产科出血报告率升高,差异有统计学意义(15.30%vs.31.35%,3.16%vs.7.84%,χ^2=2862.71,χ^2=821.99,均P<0.0001);其中严重产科出血比例由31.35%下降到干预后的9.47%,差异有统计学意义(χ^2=6304.37,P<0.0001);所有助产机构均配置了相应的产科设备、完善了产科出血综合防治制度和流程;产后2h和产后2~24h的目测法应用比例大幅下降,差异有统计学意义(93.33%vs.24.00%,96.00%vs.29.33%,χ^2=74.34,χ^2=71.24,均P<0.0001);育龄妇女产科出血知识知晓率由40.00%提高到干预后的76.66%,差异有统计学意义(χ^2=8.30,P<0.0001),助产机构医生的各项产科出血救治技术合格率均有提高;死于产科出血的孕产妇从干预前37.50%下降到22.22%。结论贵阳市农村地区产科出血综合防治干预项目取得了显著成效,所孕育的一套围绕三级预防理论的产科出血综合防治模式值得深入探索。Objective To evaluate the effectiveness of comprehensive prevention and control intervention project of obstetric hemorrhage in rural area of Guiyang City,provide a reference basis for comprehensive prevention and treatment of obstetric hemorrhage in China.Methods A prospective study was conducted,comprehensive prevention and control intervention project of obstetric hemorrhage was implemented in 75 midwifery organizations in rural area of Guiyang City. Chi-square test was used to compare the indicators before and after the intervention. Results After intervention,the detection rate of high-risk factors and the reporting rate of obstetric hemorrhage increased significantly( 15. 30%,3. 16% vs. 31. 35%,7. 84%,χ~2= 2 862. 71,χ~2= 821. 99,P<0. 000 1). The incidence rate of severe obstetric hemorrhage decreased from 31. 35% before intervention to 9. 47% after intervention,there was statistically significant difference( χ~2= 6 304. 37,P<0. 000 1). All the midwifery organizations equipped with obstetric equipments and improved comprehensive prevention and control system and process of obstetric hemorrhage. The usage rates of visual evaluation at 2 hours and within 2-24 hours after delivery decreased significantly( 93. 33%,96. 00% vs. 24. 00%,29. 33%,χ~2= 74. 34,χ~2= 71. 24,P< 0. 000 1). The awareness rate of obstetric hemorrhage knowledge among the women of childbearing age increased from 40. 00% before intervention to 76. 66% after intervention( χ~2= 8. 30,P <0. 000 1). The percent of pass of rescue technologies of obstetric hemorrhage among doctors in midwifery organizations increased. The mortality rate of pregnant women due to obstetric hemorrhage decreased from 37. 50% before intervention to 22. 22% after intervention. Conclusion The effect of comprehensive prevention and control intervention project of obstetric hemorrhage in rural area of Guiyang City is significant,the tertiary prevention theory of comprehensive prevention and control intervention model of obstetric hemorrhage is worthy of further explorat

关 键 词：产科出血 综合防治 农村地区 三级预防 

分 类 号：R173[医药卫生—妇幼卫生保健]