本文選題：孕產(chǎn)婦　切入點：死亡率　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的利用吉林省2011-2015年孕產(chǎn)婦死亡監(jiān)測數(shù)據(jù),分析吉林省2011-2015年孕產(chǎn)婦死亡率和動態(tài)變化規(guī)律及其死因分布特點,探討影響孕產(chǎn)婦死亡的原因,進(jìn)一步提出降低孕產(chǎn)婦死亡率的干預(yù)策略,為各級衛(wèi)生行政部門制定改善孕產(chǎn)婦保健服務(wù)方案提供依據(jù)。方法本次研究通過吉林省三級婦幼保健網(wǎng)絡(luò)收集相關(guān)資料,收集縣級、市(州)級、省級衛(wèi)生計生部門每季度組織相關(guān)學(xué)科的評審專家開展孕產(chǎn)婦死亡評審結(jié)果數(shù)據(jù)。對所收集數(shù)據(jù)及相關(guān)報表、報告卡進(jìn)行整理,采用Excel軟件建立數(shù)據(jù)庫并進(jìn)行描述性統(tǒng)計分析,主要分析指標(biāo)為孕產(chǎn)婦死亡率,孕產(chǎn)婦死亡相關(guān)因素和死亡評審結(jié)果分析主要采用構(gòu)成比進(jìn)行統(tǒng)計描述。結(jié)果1.吉林省2011-2015年死亡孕產(chǎn)婦176例,活產(chǎn)總數(shù)為934618,5年平均孕產(chǎn)婦死亡率為18.83/10萬。2014年吉林省孕產(chǎn)婦死亡率達(dá)到五年峰值,為25.73/10萬,動態(tài)觀察可見我省孕產(chǎn)婦死亡率已經(jīng)趨于穩(wěn)定,基本低于全國孕產(chǎn)婦死亡率平均水平。2.吉林省2011-2015五年間各市(州)孕產(chǎn)婦死亡率逐年發(fā)生變化。動態(tài)觀察可見:長春、吉林孕產(chǎn)婦死亡率控制較好,五年孕產(chǎn)婦死亡率均低于全省平均水平;四平、白城、松原孕產(chǎn)婦死亡率相對較高,五年間有四年均高于全省平均水平;其余地區(qū)與全省同期比較,也偶有高發(fā)現(xiàn)象。五年間農(nóng)村平均孕產(chǎn)婦死亡率(19.5/10萬)高于城市平均孕產(chǎn)婦死亡率(17.9/10萬)。3.五年間死亡孕產(chǎn)婦年齡集中在25-29歲年齡組,占35.8%。五年間初中及以下文化程度死亡孕產(chǎn)婦較多,占81.2%。初產(chǎn)婦多于經(jīng)產(chǎn)婦,占51.7%。孕產(chǎn)婦死于孕晚期較多,占63.6%。死亡孕產(chǎn)婦剖宮產(chǎn)者較多,占66.4%。五年間死亡孕產(chǎn)婦分娩者116例,分娩地點為省(市)醫(yī)院較多,占58.6%,死亡地點為省(市)醫(yī)院較多,占58.0%。4.吉林省2011-2015五年間死因構(gòu)成以間接產(chǎn)科死因為主(占53.4%),其次為直接產(chǎn)科死因(占44.3%)。五年間,吉林省孕產(chǎn)婦死因順位排名,第一位為產(chǎn)科出血(40例,占死因的22.7%),第二位為肺栓塞(17例,占死因的9.7%),第三位為妊娠期高血壓疾病(12例,占死因的6.8%),第四位為肺炎(10例,占死因的5.7%)。5.吉林省2011-2015五年間孕產(chǎn)婦死亡176例,根據(jù)省級評審結(jié)果:有延誤者占69.3%,其中各級醫(yī)療保健機(jī)構(gòu)處理延誤84例,占47.7%。77.3%(136/176)死亡孕產(chǎn)婦有影響因素,其中各級醫(yī)療保健人員知識技能問題48例,占35.3%,可避免死亡占51.7%。結(jié)論1.2011-2015年吉林省孕產(chǎn)婦死亡率已經(jīng)趨于穩(wěn)定,基本低于全國孕產(chǎn)婦死亡率平均水平。2.2011-2015年吉林省各市(州)孕產(chǎn)婦死亡率逐年發(fā)生變化,長春、吉林孕產(chǎn)婦死亡率控制較好,四平、白城、松原孕產(chǎn)婦死亡率相對較高。3.2011-2015年吉林省死亡孕產(chǎn)婦以農(nóng)村、25-29歲年齡組、初中及以下文化程度的初產(chǎn)婦為主,死亡多發(fā)生在孕晚期,以剖宮產(chǎn)結(jié)束分娩,分娩地點及死亡地點為省(市)級醫(yī)院較多。4.2011-2015年吉林省死亡孕產(chǎn)婦死因構(gòu)成以間接產(chǎn)科死因為主。五年間,吉林省孕產(chǎn)婦死因順位前四位為:產(chǎn)科出血、肺栓塞、妊娠期高血壓疾病、肺炎。5.2011-2015年吉林省死亡孕產(chǎn)婦176例,根據(jù)省級評審結(jié)果,51.7%的死亡孕產(chǎn)婦為可避免死亡,提示亟需進(jìn)一步提高我省孕產(chǎn)期系統(tǒng)保健服務(wù)質(zhì)量和醫(yī)療技術(shù)水平。
[Abstract]:To use 2011-2015 years of Jilin province maternal death monitoring data, analysis of Jilin province 2011-2015 years of maternal mortality and the variation and distribution characteristics of the cause of death, causes of maternal death, further reducing maternal mortality and intervention strategies, to provide evidence to improve maternal health care service for the health administrative departments at all levels. Through the study of Jilin Province three levels of maternal and child health care network to collect relevant information, collect county, city (prefecture) level, the provincial health department quarterly organize related disciplines review experts to carry out the results of the review of maternal mortality data. The collected data and related reports, report card sorting, establish database and descriptive statistical analysis by Excel software, the main analysis the index for the maternal mortality rate, maternal mortality and death related factors analysis results of the review The proportion for statistical description. The results of the 1. Jilin province 2011-2015 years of maternal deaths in 176 cases, the total number of live births for 934618,5 average maternal mortality rate was 18.83/10 million.2014 in Jilin Province, the maternal mortality rate reached a five year peak, 25.73/10 million, dynamic observation of our province maternal mortality rate has stabilized, the maternal mortality rate is lower than the national average level of basic.2. five years in Jilin province 2011-2015 municipalities (state) the maternal mortality rate year by year changes. Dynamic observation: Changchun, Jilin maternal mortality is well controlled and the rate is lower than the provincial average of five years of maternal death; Siping, Baicheng, Songyuan, the maternal mortality rate is relatively high, with an annual average of four higher than the average of five years compared with the rest; at the same time, the occasional high phenomenon. Five years rural average maternal mortality rate (19.5/10 million) higher than the city average pregnancy And the mortality rate (17.9/10 million).3. five years of maternal death age concentrated in 25-29 age group, accounting for 35.8%. five years of junior high school and below level of maternal deaths accounted for more than 81.2%. of primipara multipara, pregnant women died of late pregnancy 51.7%. accounted for more deaths accounted for 63.6%. more maternal cesarean section, 116 cases of 66.4%. accounted for five during the period of maternal deaths in childbirth, birth place of province (city) hospital more, accounted for 58.6%, the place of death for the province (city) hospital more, accounted for 58.0%.4. of Jilin Province in 2011-2015 to five years the cause of death mainly indirect obstetric causes (53.4%), followed by direct obstetric causes of death (44.3%). Five years, pregnant women in Jilin province the rank ranking first for obstetric hemorrhage (22.7% cases of 40, accounting for second deaths), pulmonary embolism (9.7% cases of 17, accounting for the cause of death, third) for hypertensive disorders in pregnancy (6.8% in 12 cases, accounting for fourth deaths), pneumonia (10 The cause of death in 5.7% cases, accounting for 2011-2015 and five.5.) of Jilin Province, 176 cases of maternal deaths, according to the provincial assessment results: delays accounted for 69.3%, the processing delay at all levels of medical institutions in 84 cases, accounting for 47.7%.77.3% (136/176) are the influencing factors of maternal mortality, including health care knowledge and skills of medical personnel at all levels in 48 cases, accounting for 35.3% conclusion 51.7%. can avoid death, accounting for 1.2011-2015 in Jilin Province, the maternal mortality rate has stabilized, the maternal mortality rate substantially below the national average in the.2.2011-2015 cities in Jilin province (state) maternal mortality rate changes year by year, Changchun, Jilin maternal mortality is well controlled, Siping, Baicheng, Songyuan, the maternal mortality rate is relatively high in Jilin province.3.2011-2015 of maternal deaths in rural areas. 25-29 years old, junior high school and below level of primipara, death occurred in late pregnancy, cesarean section in the end Delivery, delivery place and the place of death for the province (city) level hospital in Jilin province.4.2011-2015 more maternal death causes of death in indirect obstetric causes. In five years, Jilin Province Maternal Mortality four: obstetric hemorrhage, pulmonary embolism, pregnancy induced hypertension, pneumonia in Jilin province.5.2011-2015 of maternal deaths in 176 cases, according to the the provincial assessment results, 51.7% of maternal deaths to avoid death, that need to further improve our province maternal care services quality and level of medical technology.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R173

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