我国西部4省县级医疗保健机构新生儿早期基本保健服务现状

Current situation of newborn early essential health care service in county-level medical institutions of four provinces in western China

目的了解目前我国西部4省县级医疗保健机构对产妇孕产期保健服务和新生儿保健服务的提供现状,为制定完善、适宜的新生儿保健干预方案提供依据。方法采用方便抽样的方法,于2017年6月-8月选取西部4省县级助产机构的住院产妇,通过访谈和病例核查的方法,收集分娩期间接受的孕产期及新生儿早期保健服务情况。结果在完成产妇出院前访谈及分娩病例核对的221例产妇中,平均年龄为26. 00 (23. 00～29. 75)岁,少数民族占72. 85%,孕期产检平均次数为5. 00 (3. 00～8. 00)次,接受过产前母乳喂养宣传的123例(56. 16%),82例(37. 10%)产妇为剖宫产。只有166例(76. 50%)新生儿是母乳喂养,79例(36. 24%)新生儿与母亲有过皮肤接触,50例(22. 73%)新生儿在出生后进行了眼部护理,188例(85. 07%)新生儿在出生后注射了维生素K1。结论我国西部地区对产妇的孕产期保健措施仍需完善,新生儿纯母乳喂养率偏低,早接触、早吸吮、早开奶("三早")的实施也未得到普及,需加强新生儿早期基本保健措施相关的宣传和培训,促进医务人员对相关知识和技能的了解与应用。

Objective To survey the current situation of maternal health care and newborn health care service in county-level medical institutions of four provinces in western China,provide a basis for making perfect and appropriate intervention measures of newborn health care. Methods A convenience sampling method was used to select hospitalized pregnant and parturient women from county-level medical institutions of four provinces from June to August in 2017,the information of maternal health care and newborn health care service at the time of delivery were mainly collected through interview and medical records check. Results The average age of 221 participants was 26. 00 years old( 23. 00-29. 75 years old),the proportion of minority pregnant and parturient women accounted for 72. 85%,the average times of prenatal examination was 5. 00 times( 3. 00-8. 00 times),123 participants( 56. 16%) received prenatal propaganda of breastfeeding,82 participants( 37. 10%) underwent cesarean section. Only 166 neonates( 76. 50%) received breastfeeding,79 neonates( 36. 24%) contacted with maternal skin,50 neonates( 22. 73%) underwent eye care,188 neonates( 85. 07%) were injected with vitamin K1 after birth. Conclusion Maternal health care measures should be improved in western China. The rate of exclusive breastfeeding is low,and the implementation of early skin-to-skin contact,early sucking,and early breastfeeding is not achieved. Early essential newborn health care should be promoted and trained,which helps to provide the understanding and improve the practical application of relevant knowledge and skills among medical staff.