基层医院产后出血术控体系的效果评价  

Effectiveness Evaluation of Postoperative Hemorrhage Control System in Primary Hospitals

作　　者：金日男[1] 刘明烨 黄燕萍 肖文 曾立群 何碧绿 廖翠 JIN Ri-nan;LIU Ming-ye;HUANG Yan-ping;XIAO Wen;ZENG Li-qun;HE Bi-lv;LIAO Cui(Department of Obstetrics,Yuebei People's Hospital,Shaoguan 512026,China;Department of Obstetrics and Gynecology,Shaoguan First People's Hospital,Shaoguan 512023,China;Department of Obstetrics and Gynecology,Ruyuan People's Hospital,Ruyuan 512700,China;Department of Obstetrics,Ruyuan Maternal and Child Health Family Planning Service Center,Ruyuan 512700,China;Department of Obstetrics and Gynecology,Wengyuan People's Hospltal,Wengyuan 512600,China;Department of Obstetrics,Wengyuan Maternal and Child Health Family Planning Service Center,Wengyuan 512600,China)

机构地区：[1]粤北人民医院产科,广东韶关512026 [2]韶关市第一人民医院妇产科,广东韶关512023 [3]乳源县人民医院妇产科,广东乳源512700 [4]乳源县妇幼保健计划生育服务中心产科,广东乳源512700 [5]翁源县人民医院妇产科,广东翁源512600 [6]翁源县妇幼保健计划生育服务中心产科,广东翁源512600

出　　处：《中国医药指南》2020年第14期33-35,共3页Guide of China Medicine

基　　金：广东省韶关市科技计划项目(2018sn097)

摘　　要：目的探究术控体系构建在降低韶关市基层医院产后出血(postpartum hemorrhage,PPH)发生率的应用效果。方法采用临床病例对照分析,2017年及2018年至韶关市五家基层医院推行基层医院产后出血术控体系,提高PPH手术止血技能。对培训前后的PPH的病例进行统计学分析。结果韶关市基层医院经培训后总体PPH发生率降低0.44%,阴道分娩PPH发生率降低0.47%,剖宫产PPH发生率较前降低0.37%。宫缩乏力为韶关市基层医院PPH最常见的病因。胎盘因素导致PPH的病例产时出血量及产后24 h出血量均大于宫缩乏力。术控体系中所培训的四种手术止血方法应用不多,但止血成功率高。结论在韶关市基层医院推行产后出血术控体系能有效降低PPH的发生率,今后在基层医院应继续完善推广产后出血术控体系。存在胎盘因素的产妇出血量及止血失败率高于其他病因的产妇。Objective To investigate the effect of surgical control system in reducing the incidence of postpartum hemorrhage(PPH)in primary hospitals in Shaoguan.Methods Using clinical case-control analysis,in 2017 and 2018,five primary-level hospitals in Shaoguan City implemented a post-operative hemorrhage control system in primary-level hospitals to improve their hemostatic skills in PPH surgery.Statistical analysis of PPH cases before and after training.Results After training in Shaoguan City Basic Hospital,the overall incidence of PPH decreased by 0.44%,the incidence of PPH in vaginal delivery decreased by 0.47%,and the incidence of cesarean delivery decreased by 0.37%.Uterine atony is the most common cause of PPH in the primary hospitals of Shaoguan City.Placental factors leading to PPH cases of postpartum hemorrhage and 24-hour postpartum hemorrhage were greater than uterine fatigue.The four surgical hemostasis methods trained in the surgical control system are not widely used,but the hemostasis success rate is high.Conclusion The implementation of the postpartum hemorrhage surgical control system in the primary hospitals in Shaoguan City can effectively reduce the incidence of PPH.In the future,the primary hospitals should continue to improve the postpartum hemorrhage surgical control system.Maternal bleeding and hemostatic failure rates with placental factors are higher than those with other causes.

关 键 词：产后出血 基层医院 术控体系 

分 类 号：R714.46+1[医药卫生—妇产科学]