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目的了解邵阳市危重孕产妇的病因分布、医院分布及转诊情况等,为提高危重孕产妇抢救成功率、总结危重孕产妇抢救的经验与教训,加强管理,进一步降低孕产妇死亡率提供依据。方法对邵阳市2010年10月1日-2011年9月30日发生的危重孕产妇抢救案例631例进行回顾性分析。结果①抢救危重孕产妇案例中前3位病因为产科出血(61.5%)、妊娠高血压疾病(21.2%)、心衰(3.9%)。②直接产科原因540例,占85.6%,间接产科原因有91例,占14.4%。直接产科原因中宫缩乏力184例,占47.4%,中央型前置胎盘147例,占37.9%;间接产科原因中心脏病25例,占27.5%,重症肺炎12例,占13.2%。③抢救医院以市级三级医院为主,占46.0%,其次为县级产科急救中心,占27.3%。④危重孕产妇中59.0%为流动人口,75.4%为计划外妊娠。⑤转诊一次病例占29.3%,转诊两次病例占11.9%。转诊病因主要为间接产科原因,占53.9%。抢救成功631例,成功率98.4%。结论保持孕产妇急救绿色通道畅通,重视产科出血的防治,加强流动人口、计划外妊娠孕产妇的保健管理及高危、贫困救助,发挥市县两级产科急救中心的抢救优势,是提高危重孕产妇抢救成功率的有效措施。
Objective To understand the etiological distribution, hospital distribution and referral situation of critically ill pregnant women in Shaoyang city. To provide evidences for improving the success rate of critical maternal rescue, summarizing the experience and lessons of critical maternal rescue, strengthening management and further reducing maternal mortality. Methods A retrospective analysis of 631 cases of critical maternal rescue occurred in Shaoyang from October 1, 2010 to September 30, 2011 was conducted. Results ① The top three causes of rescue of critically ill pregnant women were obstetric hemorrhage (61.5%), pregnancy-induced hypertension (21.2%) and heart failure (3.9%). ② Direct obstetric reasons 540 cases, accounting for 85.6%, indirect obstetric reasons 91 cases, accounting for 14.4%. In the direct obstetric reasons, uterine atony in 184 cases, accounting for 47.4%, 147 cases of central placenta previa, accounting for 37.9%; indirect obstetric reasons 25 cases of heart disease, accounting for 27.5%, severe pneumonia in 12 cases, accounting for 13.2%. ③ Rescue hospitals are mainly municipal tertiary hospitals, accounting for 46.0%, followed by county-level obstetric emergency centers, accounting for 27.3%. ④ critically ill pregnant women 59.0% of the floating population, 75.4% of unplanned pregnancy. ⑤ referral of a case accounted for 29.3%, referral two cases accounted for 11.9%. The main cause of referral was obstetric reasons, accounting for 53.9%. 631 cases of successful rescue, the success rate of 98.4%. Conclusions Maintaining the green channel of maternity first aid, paying attention to the prevention and treatment of obstetric bleeding, strengthening the management of floating population, unplanned pregnancy maternal health management and high-risk and poor relief, Effective measure to save success rate.