河南省2005～2014年孕产妇产科出血死亡原因及相关因素分析

发布时间：2018-03-15 23:18

本文选题：孕产妇死亡　切入点：产科出血　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的孕产妇死亡率是衡量一个国家或地区的经济发展水平、文化教育事业、卫生健康状况、医疗保健事业和社会综合发展的重要指标,也是事关民生问题的一个重要指标。孕产妇健康问题是本世纪全世界范围内的主要问题之一,降低孕产妇死亡率是全球面临的一个重大难题和挑战。产科出血是孕产妇分娩期严重的并发症,威胁着孕产妇的生命安全,是孕产妇死亡首位原因。降低孕产妇死亡率是一项长期且艰巨的任务,重点在于减少产科出血的死亡。河南省作为全国第一人口大省,致力于为我国实现千年发展目标做出积极努力。本文通过对河南省2005~2014年孕产妇死亡个案研究,筛选出929例因产科出血死亡的孕产妇,进行原因及相关因素分析,为改善和提高围产期保健质量提供科学的依据,为进一步针对性降低我省孕产妇死亡率制定切实可行的干预措施。方法采取流行病学回顾性调查研究方法,收集河南省2005~2014年929例产科出血孕产妇死亡报告卡、死亡评审资料及妇幼卫生年报,将所有资料Excel录入后用SPSS21.0统计软件进行统计描述及相关分析。结果河南省2005~2014年活产数13105846例,死亡孕产妇2417例,平均死亡率18.44/10万,孕产妇死亡率总体上呈下降趋势。其中产科出血死亡929例,占死亡总数的38.44%,所占比例由2005年的54.38%下降到2014年的23.56%,呈下降趋势。产科出血以产后出血为主,比例达79.01%,死亡的主要原因为宫缩乏力和胎盘滞留。从死亡孕产妇的一般情况及构成比上看,高龄、文化程度低、经济困难者死因构成比比较高;计划外死亡孕产妇数是计划内的1.68倍。从产科出血死亡孕产妇的保健服务情况上看,孕产次数越多,产检次数越少,死亡比例越高。产后出血时间以24h以内为主占89.35%。分娩与死亡地点主要集中在区县级医院和街道(乡镇)医院,死亡评审多数为可避免死亡。结论1.河南省10年间产科出血死亡率呈逐年下降趋势。2.产科出血以产后出血为主,宫缩乏力和胎盘滞留是死亡主要原因。
[Abstract]:Objective Maternal mortality rate is an important index to measure the level of economic development, culture and education, health status, medical care and social comprehensive development of a country or region. Maternal health is one of the major issues around the world in this century. Reducing maternal mortality is a major problem and challenge facing the world. Obstetric hemorrhage is a serious complication of maternal delivery and threatens the safety of maternal life. Reducing maternal mortality is a long-term and arduous task, with the focus on reducing deaths from obstetric hemorrhage. Henan Province is the largest province with the largest population in the country. Through the case study of maternal mortality from 2005 to 2014 in Henan Province, 929 maternal deaths due to obstetric hemorrhage were selected, and the causes and related factors were analyzed. To provide scientific basis for improving and improving perinatal health care quality, and to formulate practical intervention measures for further targeted reduction of maternal mortality in our province. Methods Epidemiological retrospective investigation and research methods were adopted. From 2005 to 2014, 929 maternal mortality report cards, death assessment data and maternal and child health annual report were collected from Henan Province. All the data were recorded in SPSS21.0 statistical software for statistical description and correlation analysis. Results there were 13105846 cases of live births in Henan Province from 2005 to 2014. There were 2,417 maternal deaths, with an average mortality rate of 18.44 / 100, 000. The maternal mortality rate generally showed a downward trend, including 929 deaths from obstetric hemorrhage. The proportion of obstetrical hemorrhage was mainly postpartum hemorrhage, which decreased from 54.38% on 2005 to 23.56 on 2014. The main causes of death were uterine fatigue and placental retention. From the general situation and composition of the dead pregnant and lying-in women, the mortality ratio was higher than that of the old age, low education level and economic difficulties. The number of unplanned deaths was 1.68 times higher than planned. From the point of view of maternal health services with obstetric bleeding, the more times of pregnancy and childbirth, the less the number of birth tests. The death rate was higher. The time of postpartum hemorrhage mainly occupied 89.355.The place of delivery and death was mainly in district and county hospitals and street (township) hospitals. The mortality rate of obstetrical hemorrhage decreased year by year in Henan Province. 2. Postpartum hemorrhage was the main cause of obstetric hemorrhage. Uterine inertia and placenta retention were the main causes of death. 2.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.461

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