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目的:研究危急重症孕产妇发病的相关因素,寻求孕产妇临近死亡事件的多层次干预手段,最终降低孕产妇死亡率。方法:回顾性分析2008年1月~2012年12月期间的分娩产妇18 104名,其中69例孕产妇临近死亡病例及3例死亡病例,使用EpiInfoTM软件,采集孕产妇信息作多因素回归分析,统计并分析孕产妇临近死亡及死亡的相关危险因素和社会经济因素。结果:经过统计分析发现,流动人群孕产妇、缺乏基本医疗保险、少于6次围产期检查、发病后未能及时寻求救治均是与死亡和临近死亡孕产妇相关的高危因素;接受重症监护治疗、起病后30 min内血液制品的应用是控制病情进展的有利因素。结论:综合分析孕产妇临近死亡事件的发生可能主要与妇女孕期是否享有医疗保险及其属处社会经济地位有关;除了各级医疗保健单位,政府在社区基础医疗的投入,在降低孕产妇临近死亡事件中能够发挥重要作用。
OBJECTIVE: To study the related factors of critically ill pregnant women and seek multi-level interventions for the near death of pregnant women and eventually reduce the maternal mortality rate. Methods: A total of 18 104 pregnant women during delivery from January 2008 to December 2012 were retrospectively analyzed. Among them, 69 were maternal deaths and 3 were fatal cases. EpiInfo TM software was used to collect maternal information for multiple factor regression analysis. Statistics and analysis of maternal risk of death and death-related risk factors and socio-economic factors. Results: Through statistical analysis, it is found that the floating population pregnant women, lack of basic medical insurance, less than 6 perinatal examination, failure to seek timely treatment after the onset are the risk factors associated with death and near-death maternal; receiving intensive care Treatment, the application of blood products within 30 min after onset is a favorable factor to control the progression of the disease. Conclusions: A comprehensive analysis of the occurrence of maternal deaths may be mainly related to whether women have medical insurance and their socioeconomic status during pregnancy. In addition to the medical and health care units at all levels and the government’s investment in community basic medical care, the reduction in the number of maternal deaths Events can play an important role.