广州市海珠区2006—2010年产科质量分析

Analysis on the Related Index of Obstetric Quality from 2006 to 2010 in Haizhu,Guangzhou

目的分析2006—2010年广州市海珠区辖区助产机构产时保健开展现状及质量情况,为继续规范助产服务提供依据。方法以2006—2010年63204例产妇及63324例活产儿为对象,采用检验对不同年份、不同分娩方式及母婴分娩并发症的发生率进行对比分析。结果 2006—2010年总的剖宫产率为39.44%,总体剖宫产率呈现下降趋势;围产儿死亡率为9.67‰,分娩并发症发生率为1.94%,其中产后出血占分娩并发症的95.60%,其发生率为1.86%;剖宫产产后出血与阴道分娩产后出血发生率差异具有极显著性(χ2=38.553,P<0.01);新生儿产时并发症总发生率为1.06%,出生窒息发生率为0.98%,占总并发症的92.84%。近几年出生窒息发生率整体下降。结论海珠区近几年经过辖区行业管理以及各医疗机构的共同努力,5年剖宫产率明显低于国内有关报道。由于剖宫产增加了产后出血等产科并发症发生的危险,因此,对围产期保健工作应加强健康教育宣传,提高人民群众对剖宫产的认识,减少社会因素导致的剖宫产发生,支持和保护自然分娩。

OBJECTIVE The current study was launched to explore the present situation and quality of intrapartum care in the obstetrical establishments from 2006 to 2010, in Haihu District, Guangzhou City, in order to provide evidence for government to standardize the obstetrical service. METHODS The data of 63 204 puerperae and 63 324 live births from 2006 to 2010 was collected. We further analyzed the deliver mode and the rate of puerperal complications in different years by the method of test. RESULTS From 2006 to 2010 the total caesarean section rate was 39.44%, which showed the descending tendency, the perinatal-fetus mortality rate was 9.67%v, delivery complication rate was 1.94%, among which postpartum hemorrhage made up 95.6%, the incidence was 1.86%. The incidence was significant differences（x2=38.553 ,P〈0.01）between the postpartum hemorrhage of caesarean section and vaginal delivery. The complication incidence of newborns at birth was 1.06%, and birth asphyxia incidence was 0.98%, which made up 92.84% of the total complications. In the last five years, the birth asphyxia incidence was decreased. CONCLUSIONS With the joint effort of the trade management and medical establishments, the 5-year-rate of caesarean section was on the decline compared with the domestic relevant reports. In addition, the happening of postpartum hemorrhage and other puerperal complications increased with growing caesarean section rate. Therefore we should emphasize the health education in the perinatal health work, enhance the social recognition of caesarean section, reduce the social-cause caesarean sections, and support the spontaneous labor.