重庆市璧山县产科危重症病种及转诊指征的变化

Changes in Variations and Referral Indications of Obstetric Critical Diseases

目的探讨最近5年重庆市璧山县产科危重症病种及转诊指征变化。方法采用回顾性分析法,分析2006年1月至2010年12月在本院住院分娩的产科危重症患者201例的危重症病种分布及其中接受转诊治疗的105例重症孕产妇的病种变化(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。结果 201例产科危重症患者中,前置胎盘为67例(33.3%),产后出血为52例(25.9%),重度子痫前期为48例(23.9%),妊娠合并血小板减少为15例(7.5%),妊娠急性胰腺炎为5例(2.5%)、妊娠合并急性脂肪肝及重症肝炎为5例(2.5%),胎盘早剥为4例(1.9%),其他产科危重症为5例(2.5%)。105例采取转诊措施的主要病种为:中央型前置胎盘为36例(34.3%),早发重度子痫前期为25例(23.8%),产后出血为23例(21.9%),血小板减少为5例(4.8%),妊娠合并急性胰腺炎和妊娠急性脂肪肝为5例(4.8%)。结论最近5年重庆市璧山县产科危重症病种分布及转诊指征均有所变化。

Objective To investigate the disease entities and referral indications of obstetric critically ill patients in Bishan county, Chongqing. Methods The disease entities distribution of 201 pregnant women with obstetric critically ill who delivered in our hospital from January 2006 to December 2010 were retrospectively analyzed. Among them, the changes of disease entities of 105 cases who received referral treatment were also analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of People＇s Hospital of Bishan County, Chongqing. Informed consent was obtained from all participants. Results Among those 201 cases with obstetric critically ill patients, 67 cases （33.3%） were placenta previa, 52 cases （25. 9%） were postpartum hemorrhage, 48 cases （23. 9%） were severe preeelampsia, 15 cases （7.5%） were pregnancy thrombocytopenia, 5 cases （2.5%） were acute pancreatitis, 5 cases （2.5%） were pregnancy combined with severe hepatitis and acute fatty liver, 4 cases （1.9%） were placental abruption and 5 cases （2.5 %） were other obstetric critically ill. The major disease entities of other 105 cases who received referral treatment were central placenta previa （36/105, 34.3%）, early onset pre- eelampsia （25/105, 23.8%）, severe postpartum hemorrhage （23/105, 21.9%）, thrombocytopenia during pregnancy （5/105, 4.8%）, pregnancy complicating with acute pancreatitis and acute fatty liver （5/105, 408%）. Conclusion The disease entities and referral indications of obstetric critically ill patients in Bishan country have been changed during last five years.