建立产科ICU实施分类监护降低产科风险的尝试

The attempt of establishing prenatal ICU to reduce obstetrics risks

目的探讨一种有效降低产科风险的工作和管理模式。方法建立产前监护室、产后监护室、新生儿监护室，加强各监护室硬件设施的投入、各项制度的建设、人员的培训和考核、质量控制，根据人室标准筛选高危孕产妇及新生儿，对其实施分类连续动态监护。将分类监监护前3年的5664例作为对照组，以分类监护实施后的5821例作为观察组，比较两组孕产妇死亡率、新生儿死亡率、投诉率、不良医疗事件发生率。结果实施前后产科的投诉率、孕产妇死亡率、新生儿死亡率、不良医疗事件发生率进行比较，结果投诉率及不良医疗事件发生率明显下降，降低了孕产妇和新生儿的死亡率。结论建立产科ICU，实施分类监护，是降低产科风险，确保孕产妇和新生儿安全的重要措施。

Objective To explore a management model which can effectively reduce obstetrics risks. Methods Establish prenatal care unit and post - natal care unit, neonatal intensive care unit and strengthen the hardware facilities of the intensive care unit, the con- struction of the system, personnel training and assessment, quality control. According the admission criteria, high - risk pregnant women and newborns were screen, then classified dynamic continuous guardianship was implemented. Results The complaint rate and the inci- dence of adverse medical events were decreased significantly and the maternal and neonatal mortality were reduced. Conclusions The obstetric ICU and implementation of the classified custody are important measures which can reduce the obstetric risks and ensure the safety of maternal and newborns, especially in 2 or 3 General Hospital where they have very good prospects for promotion.