2016~2020年中国阴道分娩并发症发生现状调查  

Investigation on the Incidence of Vaginal Delivery Complications between 2016 and 2020 in China

作　　者：石慧峰 陈练[1] 尹韶华 魏瑗[1] 王晓霞[1] 卢㛃 葛霖[1] 乔杰[1] 赵扬玉[1] SHI Huifeng;CHEN Lian;YIN Shaohua(National Centre for Healthcare Quality Management in Obstetrics,Department of Obstetrics and Gynaecology,Peking University Third Hospital,National Clinical Research Centre for Obstetrics and Gynaecology,Beijing 100191.China)

机构地区：[1]国家产科专业医疗质量控制中心,北京大学第三医院妇产科国家妇产疾病临床医学研究中心,北京100191

出　　处：《实用妇产科杂志》2022年第1期13-17,共5页Journal of Practical Obstetrics and Gynecology

基　　金：北京大学第三医院队列建设项目(编号:BYSYDL2019001)。

摘　　要：目的:对2016~2020年全国阴道分娩并发症发生率及疾病谱进行调查,为阴道分娩并发症防治策略的制定和评估提供数据支持。方法:使用2016~2020年医院质量监测系统(HQMS)15~49岁阴道分娩孕产妇数据(2016~2020年纳入三级医院数据,2020年纳入二级医院数据)。阴道分娩并发症病例通过国际疾病分类第10次修订版(ICD-10)编码识别。结果:共纳入15~49岁阴道分娩孕产妇14445908例。2020年阴道分娩并发症总体发生率为18.7%,在二级、三级医院分别为14.7%和22.3%,阴道分娩并发症在三级医院中的发生率从2016年的11.9%上升到2020年的22.3%。2020年阴道分娩并发症发生率最高的前2位亚类依次为产科裂伤、产后出血,在三级医院发生率分别为11.9%、5.7%,在二级医院发生率分别为8.9%、3.7%;产科裂伤中分娩时Ⅲ度、Ⅳ度会阴裂伤在三级医院发生率分别为0.055%、0.015%,在二级医院发生率分别为0.049%、0.013%。2020年阴道分娩产后出血总体发生率为4.8%,2016~2019年三级医院监测数据显示产后出血发生率从3.8%上升到6.4%,一直处于阴道分娩并发症疾病谱顺位首位。结论:全国阴道分娩产妇并发症发生率较高,以产科裂伤和产后出血最为常见。建议在规范疾病诊断编码的基础上,从促进分娩安全管理、提高助产技术和完善妊娠风险评估管理等多方面入手,针对阴道分娩并发症重点病种开展有针对性的质量改进措施。Objective:To present the incidence and spectrum of vaginal delivery complications in China between 2016 and 2020,so as to provide data support for the formulationand evaluation of prevention and treatment strategies for vaginal delivery complications.Methods:We did a retrospective analysis using data of 15-49 years old pregnant women with vaginal delivery drawn from the Hospital Quality Monitoring System(HQMS)from 2016 to 2020 in China,including data of tertiary hospitals from 2016 to 2020 and secondary hospitals in 2020.Diagnoses of vaginal delivery complications were identified by using the codes of the International Classification of Diseases-10 th Revision.Results:A total of 14445908 pregnant women with vaginal delivery aged 15-49 were included.In 2020,the overall incidence of vaginal delivery complications was 18.7%,14.7%and 22.3%in secondary and tertiary hospitals respectively.The incidence of vaginal delivery complications in tertiary hospitals increased from 11.9%in 2016 to 22.3%in 2020.The top two vaginal delivery complications with the highest incidence were obstetric laceration(11.9%in tertiary hospitals and 8.9%in secondary hospitals)and postpartum hemorrhage(5.7%in tertiary hospitals and 3.7%in secondary hospitals)in 2020.The incidence of third-and fourth-degree perineal laceration rate was 0.055%and 0.015%in tertiary hospitals and 0.049%and 0.013%in secondary hospitals,respectively.The overall incidence of postpartum hemorrhage was 4.8%in 2020.The monitoring data of tertiary hospitals from 2016 to 2019 showed that the incidence of postpartum hemorrhage increased from 3.8%to 6.4%,ranking first in the disease spectrum of vaginal delivery complications.Conclusions:The incidence of maternal complications of vaginal delivery is high in China,and obstetric laceration and postpartum hemorrhage are the most common.On the basis of standardizing the disease diagnosis code,it is suggested to carry out targeted quality improvement measures for key diseases of vaginal delivery complications from the aspects of p

关 键 词：阴道分娩 并发症 产后出血 发生率 中国 

分 类 号：R714.46[医药卫生—妇产科学]