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目的:探讨弥勒市产科出血病因的变化趋势及防治项目工作进展情况。方法:选取弥勒市2013年4月-6月未参与产科出血防治项目的 1 418例产妇和2013年10月-2014年3月参与产科出血综合防治项目的 3 219例产妇作为研究对象。其中2013年10月-2013年12月产妇1 692例,2014年1月-2014年3月产妇1 527例,对产妇产科出血情况资料和防治项目工作的数据进行分析。结果:三个阶段中孕产期合并性贫血(12.48%,9.23%,9.76%)、瘢痕子宫(7.56%,8.56%,8.47%)和宫缩乏力(71.32%,72.78%,73.33%)是产科出血的主要病因。此外,剖宫分娩出血率(27.91%,27.36%,26.73%)高于阴道分娩出血率(2.98%,2.62%,2.80%),差异均具有统计学意义(P<0.05)。结论:产科出血病因更加趋向于多样化,目前孕产期合并性贫血、疤痕子宫和宫缩乏力仍是产科出血的主要原因,因此在进行产科出血防治时应对孕产期合并性贫血、疤痕子宫和宫缩乏力进行针对性防治,同时鼓励孕产妇采用阴道分娩,尽可能避免剖宫分娩。
Objective: To investigate the changing trend of the causes of obstetric hemorrhage in Maitreya and the progress of prevention and treatment projects. Methods: A total of 1 418 maternal women who did not participate in the obstetric bleeding prevention and control project from April to June 2013 in Maitreya and 3 219 maternal women who participated in the integrated obstetric bleeding prevention and control project from October 2013 to March 2014 were selected as research subjects. Among them, 1 692 maternal from October 2013 to December 2013 and 1 527 maternal from January 2014 to March 2014 were analyzed. Data of maternal obstetric bleeding and prevention and control work were analyzed. Results: The incidence of maternal anemia (12.48%, 9.23%, 9.76%), scarring uterus (7.56%, 8.56%, 8.47%) and uterine atony (71.32%, 72.78%, 73.33%) were The main cause of obstetric hemorrhage. In addition, the rate of bleeding after cesarean section (27.91%, 27.36%, 26.73%) was higher than that of vaginal delivery (2.98%, 2.62%, 2.80%). The differences were statistically significant (P <0.05). Conclusion: The cause of obstetric hemorrhage tends to be more diversified. At present, maternal anemia, scar uterus and uterine atony are still the main causes of obstetric hemorrhage. Therefore, in the prevention and treatment of obstetric hemorrhage, And uterine inertia targeted prevention and treatment, while encouraging pregnant women to use vaginal delivery, as far as possible to avoid cesarean section delivery.