危重孕产妇特征、病因构成及转诊救治情况研究

Study on the Characteristics, Etiology and Diagnosis and Treatment of Critically Ill Pregnant Women

目的:分析危重孕产妇的临床特征、病因构成以及转诊救治等情况,从而提高对危重孕产妇的抢救效果,降低孕产妇死亡率。方法:选取576例2015年1月-2017年6月抢救的危重孕产妇,对其临床治疗进行回顾分析和总结。结果:576例危重孕产妇均救治成功,其中流动人口占比67.53%,计划外妊娠占比67.53%。病因以直接产科原因为主,其中产科出血占比47.92%,异位妊娠和妊娠高血压分别占比10.24%和19.96%。间接产科原因以妊娠合并心脏病、合并糖尿病和重症肝炎等占比较大。产科出血原因主要为宫缩乏力(47.10%)、中央前置胎盘(33.70%)、胎盘早剥(14.13%)和子宫破裂(5.07%),危重孕产妇救治以辖区产科救治中心救治为主。结论:加强对危重孕产妇产科出血的防治,强化对计划外妊娠产妇和流动人口的监测,及时对高危孕产妇实施有效干预,预防和控制危重孕产妇病情,提高救治效果。

Objective： To analyze the clinical characteristics, etiological constitution and referral treatment of critical pregnant women, so as to improve the rescue effect of critical pregnant and lying in pregnant women and reduce the mortality of pregnant and lying in women. Methods： 576 critically ill pregnant women who were rescued in January 2015-June 2017 were selected for retrospective analysis and summary of their clinical treatment. Results： 576 cases of critical pregnant women were successfully treated, of which 67.53% were floating population and 67.53% of unplanned pregnancies. The main causes were direct obstetric causes, including47.92% of obstetric hemorrhage, 10.24% of ectopic pregnancy and 19.96% of pregnancy induced hypertension. The cause of indirect obstetrics is pregnancy, heart disease, diabetes mellitus and severe hepatitis. The main causes of obstetric bleeding were uterine inertia（47.10%）, placenta previa（33.70%）, placental abruption（14.13%） and rupture of uterus（5.07%）. The treatment of critical pregnant women was mainly treated by obstetric care center. Conclusion： strengthening the prevention and treatment of Obstetrics and maternity bleeding, strengthening the monitoring of pregnant women and floating population, effective intervention in high risk pregnant and lying in women in time, preventing and controlling the condition of critical pregnant and parturient women, and improving the effect of treatment.