2001至2011年深圳市异位妊娠死亡情况分析

Analysis of death status of ectopic pregnancy from 2001 to 2011 in Shenzhen

目的分析深圳市2001至2011年异位妊娠死亡情况，探讨影响异位妊娠孕产妇死亡的因素，为进一步制定预防措施提供依据。方法回顾性分析2001至2011年深圳市所有异位妊娠死亡孕产妇个案及其评审资料。结果①深圳市全人口孕产妇死亡率从2001年的77．47／10万下降到2011年的9．89／10万，平均下降速度8．97％；全人口异位妊娠死亡专率从2001年的5．95／10万下降到2011年的1．63／10万，但孕产妇异位妊娠的死亡构成比在2010年、2011年上升明显，分别占当年死因排序的第2位；②2001年、2011年异位妊娠导致的孕产妇死亡共26例，占孕产妇死亡总数的7．03％，异位妊娠死亡专率为1．89／10万。其中：流动人口16例，占61．54％；未婚11例，占42．31％；中学及以下文化程度13例，占50．00％；最高孕次为10次；⑧影响死亡的主要特征因素有：个人保健意识不足占90％，临床症状不典型、早期处理中误诊急性胃肠炎；延迟诊断等相关环节问题占53．84％。结论对孕产妇实现全覆盖管理，加强健康教育，提高孕产妇的自我保健意识；同时需加强医疗队伍建设，提高急救、诊断与治疗技术，降低异位妊娠的死亡率。

Objective To access the death status of ectopic pregnancy （EP） from 2001 to 2011 in Shenzhen and discuss the influencing factors, so as to supply scientific foundation for further prevention. Methods The data of all dead cases of EP and death assessment data during this period were analyzed retrospectively. Results The maternal mortality rate of whole population in Shenzhen declined from 77.47/ 100 000 in 2001 to 9.89/100 000 in 2011, and the average descending rate was 8.97%. The mortality of EP in the whole population dropped from 5.95/100 000 in 2001 to 1.63/100 000 in 2011, but the ratio of mortality of EP rose significantly in 2010 and 2011 and ranked at second place in that year. There were 26 deaths of EP from 2001 to 2011 in Shenzhen city, which occupied 7.03% of all death cases in pregnant women, and the mortality of EP was 1.89/100 000. Among them, 16 patients were migrant people （61.54%） , 11 patients were unmarried （42.31%） , and 13 patients dropped out before high school （50.00%）. The highest number of pregnancies reached to 10. Of the major influencing factors, insufficient self-care awareness occupied 90% , while atypical symptoms, misdiagnosed as acute gastroenteritis at early treatment and delayed diagnosis occupied 53.84%. Conclusion In order to reduce the mortality of EP, overall management should be realized, health education for pregnant women be enhanced and their self-consciousness be improved. Meanwhile, the medical team construction should be strengthened, and the technique of emergency, diagnosis and treatment need to he improved.