萊蕪市2013-2017年孕產(chǎn)婦死亡監(jiān)測結(jié)果分析

王靜 亓婷婷

摘要 目的：通過對萊蕪市2013-2017年孕產(chǎn)婦死亡監(jiān)測結(jié)果分析，掌握萊蕪市戶籍孕產(chǎn)婦死亡變化趨勢、死亡原因及影響因素，有針對性地提出干預(yù)措施，降低孕產(chǎn)婦死亡率。方法：對萊蕪市2013-2017年孕產(chǎn)婦死亡監(jiān)測資料進行分析。結(jié)果：萊蕪市5年間孕產(chǎn)婦死亡13例，孕產(chǎn)婦死亡率23.18/10萬;直接產(chǎn)科死因8例（61.5%），間接產(chǎn)科死因5例（38.5%）;孕產(chǎn)婦死亡原因前3位依次為產(chǎn)科出血4例（30.8%）、羊水栓塞3例（23.1%）、妊娠合并肝病2例（15.4%）。結(jié)論：萊蕪市在過去5年間，孕產(chǎn)婦死亡率得到了很好控制，但也面臨嚴峻形勢。因此，需進一步完善三級婦幼保健網(wǎng)絡(luò)，開展分級診療，提高孕產(chǎn)婦系統(tǒng)管理和高危妊娠管理質(zhì)量;加強產(chǎn)科能力建設(shè)，完善急危重癥孕產(chǎn)婦轉(zhuǎn)運網(wǎng)絡(luò)，暢通急救綠色通道，提高救治水平。

關(guān)鍵詞 孕產(chǎn)婦死亡;監(jiān)測;原因分析;萊蕪

Analysis of monitoring results of matemal deaths from 2013 t0 2017 in Laiwu cityWang Jing1， Qi Tingting2

Abstract Objective：Based on the analysis of monitoring results of maternal deaths from 2013 t0 2017 in Laiwu city，this paperaims to master the trend.cause and influencing factors of maternal deaths in Laiwu and propose targeted interventions to reducematernal mortality.Methods：The monitoring data of maternal morcalicy in Laiwu from 2013 t0 2017 were analyzed.Results：Therewere 13 maternal deaths in Laiwu in five years，and the maternal mortality rate was 23.18/100000.There were 8 direct obstetriccauses of death，accounting for 61.5%.and 5 indirect causes of death，accounting for 38.5%.The top 3 causes of maternal mortalitywere 4 cases of obstecric hemorrhage（30.8%），3 cases of amniotic emholism（23.l%）.and 2 cases of gestational complicated liverdisease（15.4%）.Conclusion：The maternal mortality rate has been well controlled in Laiwu over the past five years，but it also facesa serious situation.Therefore.it is necessary to furcher improve the three-level maternal and child health care network，carry outgraded diagnosis and treatment，and improve the quality of maternal system management and high-risk pregnancy management.Furthermore，it also important to strengthen capacity huilding in ohstetrics，improve the transport network for critically ill pregnantwomen and ensure that green channels for first aid are accessible.

Key words

Maternal death; Monitoring;Cause analvsis;Laiwu

孕產(chǎn)婦死亡率是衡量經(jīng)濟社會和人類發(fā)展的重要綜合性指標(biāo)，客觀分析影響孕產(chǎn)婦死亡的原因，有利于制定相應(yīng)的干預(yù)措施，降低孕產(chǎn)婦死亡率。本文對萊蕪市2015-2017年孕產(chǎn)婦死亡情況進行了研究分析。

資料與方法

資料來源于2013-2017年婦幼衛(wèi)牛年報表和孕產(chǎn)婦死亡監(jiān)測資料。

方法：根據(jù)全市基層婦幼保健結(jié)構(gòu)上報的2013-2017年孕產(chǎn)婦死亡報告卡、孕產(chǎn)婦死亡監(jiān)測質(zhì)量控制調(diào)查表，對死亡病例進行調(diào)查、核實，由萊蕪市衛(wèi)計委組織全市孕產(chǎn)婦死亡評審小組，依據(jù)世界衛(wèi)牛組織“十二表格”評審法，對孕產(chǎn)婦死因、診治、搶救以及存在問題等進行死亡評審。

結(jié)果

孕產(chǎn)婦死亡情況：2013-2017年全市活產(chǎn)數(shù)61 008例，孕產(chǎn)婦死亡13例，孕產(chǎn)婦平均死亡率23.18/10萬，見表l。……