中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2015年
3期
429-431
,共3页
高群%宋波%熊玮仪%罗晓敏
高群%宋波%熊瑋儀%囉曉敏
고군%송파%웅위의%라효민
农村地区%助产机构%产科出血%高危因素%筛查
農村地區%助產機構%產科齣血%高危因素%篩查
농촌지구%조산궤구%산과출혈%고위인소%사사
rural area%midwifery institutions%obstetric hemorrhage%high risk factor%screening
目的：了解农村地区助产机构产科出血相关高危因素筛查状况及存在的问题。方法采用横断面的调查方法,收集3个省6个县124所助产机构2013年产科出血相关高危因素的筛查信息,包括高危筛查工作开展情况、高危筛查服务项目提供情况及产科出血相关高危因素检出情况。结果在124所助产机构中,有74.19%开展了高危筛查工作,有55.65%设置了高危门诊；开展凝血功能检查、妊娠图和产程图绘制的比例分别为50.81%、49.19%、65.32%,县级医院3项服务项目开展比例均高于乡镇卫生院,经比较差异均有统计学意义(χ2值分别为11.201、4.119、11.472,均P<0.05)；产科出血相关高危因素检出率为25.17%,其中公立医院检出率(27.48%)高于民营医院(14.91%),经比较差异有统计学意义(χ2=162.217,P=0.000),县级医院检出率(30.20%)高于乡镇级医院(15.99%),经比较差异有统计学意义(χ2=165.442,P=0.000)；高危因素前3位分别为贫血(9.49%)、瘢痕子宫(9.05%)和巨大儿(2.31%)。结论农村地区助产机构产科出血相关高危因素筛查工作开展不足,急需完善高危门诊的设置,加强对民营医院及乡镇医院的管理,规范高危因素筛查及管理,减少产科出血的发生。
目的：瞭解農村地區助產機構產科齣血相關高危因素篩查狀況及存在的問題。方法採用橫斷麵的調查方法,收集3箇省6箇縣124所助產機構2013年產科齣血相關高危因素的篩查信息,包括高危篩查工作開展情況、高危篩查服務項目提供情況及產科齣血相關高危因素檢齣情況。結果在124所助產機構中,有74.19%開展瞭高危篩查工作,有55.65%設置瞭高危門診；開展凝血功能檢查、妊娠圖和產程圖繪製的比例分彆為50.81%、49.19%、65.32%,縣級醫院3項服務項目開展比例均高于鄉鎮衛生院,經比較差異均有統計學意義(χ2值分彆為11.201、4.119、11.472,均P<0.05)；產科齣血相關高危因素檢齣率為25.17%,其中公立醫院檢齣率(27.48%)高于民營醫院(14.91%),經比較差異有統計學意義(χ2=162.217,P=0.000),縣級醫院檢齣率(30.20%)高于鄉鎮級醫院(15.99%),經比較差異有統計學意義(χ2=165.442,P=0.000)；高危因素前3位分彆為貧血(9.49%)、瘢痕子宮(9.05%)和巨大兒(2.31%)。結論農村地區助產機構產科齣血相關高危因素篩查工作開展不足,急需完善高危門診的設置,加彊對民營醫院及鄉鎮醫院的管理,規範高危因素篩查及管理,減少產科齣血的髮生。
목적：료해농촌지구조산궤구산과출혈상관고위인소사사상황급존재적문제。방법채용횡단면적조사방법,수집3개성6개현124소조산궤구2013년산과출혈상관고위인소적사사신식,포괄고위사사공작개전정황、고위사사복무항목제공정황급산과출혈상관고위인소검출정황。결과재124소조산궤구중,유74.19%개전료고위사사공작,유55.65%설치료고위문진；개전응혈공능검사、임신도화산정도회제적비례분별위50.81%、49.19%、65.32%,현급의원3항복무항목개전비례균고우향진위생원,경비교차이균유통계학의의(χ2치분별위11.201、4.119、11.472,균P<0.05)；산과출혈상관고위인소검출솔위25.17%,기중공립의원검출솔(27.48%)고우민영의원(14.91%),경비교차이유통계학의의(χ2=162.217,P=0.000),현급의원검출솔(30.20%)고우향진급의원(15.99%),경비교차이유통계학의의(χ2=165.442,P=0.000)；고위인소전3위분별위빈혈(9.49%)、반흔자궁(9.05%)화거대인(2.31%)。결론농촌지구조산궤구산과출혈상관고위인소사사공작개전불족,급수완선고위문진적설치,가강대민영의원급향진의원적관리,규범고위인소사사급관리,감소산과출혈적발생。
Objective To understand the screening status of high risk factors of obstetric hemorrhage and problems in screening in rural midwifery institutions. Methods In 2013 cross-sectional survey was used to collect relevant screening information on high risk factors of obstetric hemorrhage among 124 midwifery institutions in 6 counties of 3 provinces, including the situation of screening work, provided services for high risk screening and the detection rate of high risk factors. Results Of 124 midwifery institutions, 74. 19% had conducted high risk factors screening and 55. 65% had set high-risk clinics. The percentages of the use of blood coagulation check, pregnancy map drawing and application of partogram were 50. 81%, 49. 19% and 65. 32% respectively. More county leveled hospitals had conducted all these three services than township leveled ones, and the differences were significant (χ2 value was 11. 201, 4. 119 and 11. 472, respectively, all P<0. 05). The detection rate of high risk factors of obstetric hemorrhage was 25. 17%. That of government hospitals (27. 48%) was higher than private ones (14. 91%) and that of county leveled hospitals (30. 20%) was higher than township leveled ones (15. 99%) with significant differences (χ2 value was 162. 217 and 165. 442, respectively, both P =0. 000). The top three high risk factors were anemia (9. 49%), scarred uterus (9. 05%) and macrosomia (2. 31%). Conclusion The screening of high risk factors of obstetric hemorrhage in rural midwifery institutions is inadequate. It is urgent to complete the setting of high-risk clinics, enhance the management of private and township leveled hospitals, standardize high risk screening and management, and reduce the incidence of obstetric hemorrhage.
