本文選題：孕產(chǎn)婦死亡　切入點：產(chǎn)科出血　出處：《鄭州大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的孕產(chǎn)婦死亡率是衡量一個國家或地區(qū)的經(jīng)濟發(fā)展水平、文化教育事業(yè)、衛(wèi)生健康狀況、醫(yī)療保健事業(yè)和社會綜合發(fā)展的重要指標,也是事關民生問題的一個重要指標。孕產(chǎn)婦健康問題是本世紀全世界范圍內的主要問題之一,降低孕產(chǎn)婦死亡率是全球面臨的一個重大難題和挑戰(zhàn)。產(chǎn)科出血是孕產(chǎn)婦分娩期嚴重的并發(fā)癥,威脅著孕產(chǎn)婦的生命安全,是孕產(chǎn)婦死亡首位原因。降低孕產(chǎn)婦死亡率是一項長期且艱巨的任務,重點在于減少產(chǎn)科出血的死亡。河南省作為全國第一人口大省,致力于為我國實現(xiàn)千年發(fā)展目標做出積極努力。本文通過對河南省2005~2014年孕產(chǎn)婦死亡個案研究,篩選出929例因產(chǎn)科出血死亡的孕產(chǎn)婦,進行原因及相關因素分析,為改善和提高圍產(chǎn)期保健質量提供科學的依據(jù),為進一步針對性降低我省孕產(chǎn)婦死亡率制定切實可行的干預措施。方法采取流行病學回顧性調查研究方法,收集河南省2005~2014年929例產(chǎn)科出血孕產(chǎn)婦死亡報告卡、死亡評審資料及婦幼衛(wèi)生年報,將所有資料Excel錄入后用SPSS21.0統(tǒng)計軟件進行統(tǒng)計描述及相關分析。結果河南省2005~2014年活產(chǎn)數(shù)13105846例,死亡孕產(chǎn)婦2417例,平均死亡率18.44/10萬,孕產(chǎn)婦死亡率總體上呈下降趨勢。其中產(chǎn)科出血死亡929例,占死亡總數(shù)的38.44%,所占比例由2005年的54.38%下降到2014年的23.56%,呈下降趨勢。產(chǎn)科出血以產(chǎn)后出血為主,比例達79.01%,死亡的主要原因為宮縮乏力和胎盤滯留。從死亡孕產(chǎn)婦的一般情況及構成比上看,高齡、文化程度低、經(jīng)濟困難者死因構成比比較高;計劃外死亡孕產(chǎn)婦數(shù)是計劃內的1.68倍。從產(chǎn)科出血死亡孕產(chǎn)婦的保健服務情況上看,孕產(chǎn)次數(shù)越多,產(chǎn)檢次數(shù)越少,死亡比例越高。產(chǎn)后出血時間以24h以內為主占89.35%。分娩與死亡地點主要集中在區(qū)縣級醫(yī)院和街道(鄉(xiāng)鎮(zhèn))醫(yī)院,死亡評審多數(shù)為可避免死亡。結論1.河南省10年間產(chǎn)科出血死亡率呈逐年下降趨勢。2.產(chǎn)科出血以產(chǎn)后出血為主,宮縮乏力和胎盤滯留是死亡主要原因。
[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.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R714.461

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