四川省医务人员产后出血诊治掌握情况的现状调查

Investigation on the current situation of knowledge about diagnosis and treatment of postpartum hemorrhage among medical staff in Sichuan province

目的:调查四川省各级医务人员产后出血相关知识和技能掌握情况。方法:设计产后出血培训问卷,对1 000余名医务人员进行10次产后出血诊治培训,并抽取500名进行问卷调查。结果:402份有效问卷中产后出血病因判断类题目及产后出血处理流程类题目的正确率均在85%以上,但产后失血量估计类题目的正确率低于45%,第三产程规范化处理预防产后出血类题目的正确率仅为32%,答题错误者主要为低年资住院医生。402人中会进行B-Lynch缝合、子宫动脉结扎及知晓剖宫产子宫切除术技巧者均不足1/3。402人均对本次培训表示支持,并期望更多类似培训。结论:各级产科医生对产后出血量的估计、宫缩剂的正确应用及手术止血方法的掌握尚存在问题,应加强相关理论及手术操作技能的培训。

Objective： To investigate the knowledge and skills about diagnosis and treatment of postpartum hemorrhage among med- ical staff in Sichuan province. Methods ： A self - designed training questionnaire about postpartum hemorrhage was used to train diagnosis and treatment of postpartum hemorrhage for 10 times among more than 1 000 medical workers, 500 medical workers were abstracted for ques- tionnaire investigation. Results： Among 402 valid questionnaires, the correct rates of questions about judgment of causes and treatment scheme of postpartum hemorrhage were more than 85% ; the correct rate of questions about estimation of bleeding volume of postpartum hem- orrhage was lower than 45%, the correct rate of normalized treatment and prevention of postpartum hemorrhage during the third stage of labor was only 32% , the resident doctors with low seniority were prone to make mistakes when investigated; less than 1/3 of the medical workers grasped the skills of B - Lynch suture, uterine artery ligation and hysterectomy ; all the 402 medical workers supported this training and they expected more trainings like this. Conclusion： Obstetricians at all levels have problems in assessing postpartum bleeding volume, applying uterotonic correctly, and grasping surgery of stopping bleeding, related theory and training of surgical operating skill should be strengthened.