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目的分析湖南省2011-2015年产科出血致孕产妇死亡的动态变化趋势,探讨其主要死因构成及相关影响因素,为今后湖南省预防产科出血致孕产妇死亡提供一定的理论依据。方法收集湖南省2011-2015年191例产科出血死亡孕产妇的监测资料及评审结果,采用描述性统计方法分析湖南省产科出血死亡孕产妇的死因构成及死亡特征,应用趋势性卡方检验分析湖南省2011-2015年产科出血孕产妇死亡率的变化趋势。结果 1)2011-2015年湖南省孕产妇死亡率、产科出血孕产妇死亡率均呈下降趋势(P<0.05);2)产科出血致孕产妇死亡的原因中以宫缩乏力最为常见,占46.07%,其次为子宫破裂(12.04%)和前置胎盘(10.99%);3)产科出血死亡孕产妇产检大于等于5次者占56.02%,分娩和死亡地点在县级医院比例分别为38.74%和37.70%;4)评审结论表明产科出血孕产妇死亡病例中96.34%为可避免死亡。结论加强产科人员的专业知识技能培训,提高县乡级医疗机构孕产期保健服务质量是降低产科出血孕产妇死亡的有效措施。
Objective To analyze the dynamic changes of maternal deaths caused by obstetric hemorrhage during 2011-2015 in Hunan province and to explore the main cause of death and its related factors so as to provide some theoretical evidences for the prevention of maternal death from obstetric hemorrhage in Hunan Province in the future. Methods The data and results of 191 maternal deaths from obstetric hemorrhage in Hunan province during 2011-2015 were collected. Descriptive statistics were used to analyze the cause of death and the causes of death of pregnant women who died of obstetric hemorrhage in Hunan Province. The trend chi-square test was used to analyze Hunan The trend of maternal mortality in obstetrics and gynecology from 2011 to 2015 in province. Results 1) The maternal mortality rate and the maternal mortality rate of obstetric hemorrhage all showed a decreasing trend from 2011 to 2015 in Hunan (P <0.05); 2) The most common uterine inertia occurred in the causes of maternal mortality in maternity bleeding, accounting for 46.07 %, Followed by uterine rupture (12.04%) and placenta previa (10.99%); 3) deaths of obstetric hemorrhage pregnant women accounted for 56.02% or more than five times the place of delivery and death in the county hospital were 38.74% and 37.70%; 4) The review concluded that 96.34% of maternal deaths in obstetric hemorrhage were avoidable deaths. Conclusion It is an effective measure to reduce the maternal death in obstetric hemorrhage by strengthening professional knowledge and skill training of obstetricians and improving the quality of maternal health service at county and township medical institutions.