系统性院前急救措施对急危重症孕产妇救治效果及其妊娠结局

The effect of systemic pre hospital first aid measures for treating emergency and critical pregnant women and its influence on pregnancy outcomes

目的:探讨系统性院前急救措施对急危重症孕产妇救治效果及妊娠结局影响。方法:回顾性分析不同时期本院救治的92例急危重症孕产妇临床资料,其中46例(观察组)采用系统性院前急救措施,46例(对照组)采用传统院前急救措施。观察两组救治效果、急诊效率及母婴结局。结果:观察组救治有效率(91.3%)高于对照组(73.9%),接诊时间(3.3±0.3)min)、转运时间(23.2±6.0min)短于对照组(5.3±1.5min、34.2±8.0min),意外和医疗纠纷发生率(2.2%)低于对照组(15.2%),抢救成功率(93.5%)高于对照组(69.6%),胎儿宫内窘迫率、子痫、早产(过期)产儿、巨大儿(低出生体重儿)、产后出血、总不良发生率(42.9%)均低于对照组(70.4%),新生儿出生1、5min Apgar评分(9.7±0.4分、9.8±0.0分)高于对照组(9.1±0.6分、9.6±0.3分),新生儿重度窒息(4.4%)、新生儿死亡率(0.0%)低于对照组(19.6%、8.7%)(均P<0.05)。结论:系统性院前急救措施可提高急危重症初产妇救治成功率,缩短出诊、转诊时间,改善母婴结局。

Objective:To explore the effect of systemic pre hospital first aid measures for treating emergency and critical pregnant women,and to study its influence on pregnancy outcomes.Methods:A retrospective analysis was conducted for analyzing the clinical data of 92 emergencies and critical pregnant women,which included 46 women in observation group who had received systematic pre hospital first aid measures,and 46 women in control group who had received traditional pre hospital first aid measures.The treatment effect,emergency efficacy,and maternal and infant outcomes of women in both groups were observed.Results:The effective rate of women in the observation group was 91.3%,which was significant higher than that(73.9%)of women in the control group(P<0.05).The time of consultation and transit time of women in the observation group were 3.3±0.3 min and 23.2±6.0 min,which were significant higher than those(5.3±1.5 min and 34.2±8.0min)shorter than that of the control group(P<0.05).The incidence of accident and medical disputes of women in the observation group was 2.2%,which was significant lower than that(15.2%)of women in the control group(P<0.05).The success rate of rescue of women in the observation group was 93.5%,which was significant lower than that(69.6%)of women in the control group(P<0.05).The total adverse rate(intrauterine distress,eclampsia,premature/expired birth,macrosomia,low birth weight infants,postpartum hemorrhage)of women in the observation group was 42.9%,which was significant lower than that(70.4%)of women in the control group(P<0.05).Apgar scores of newborn at 1 and 5 min after birth in the observation group were 9.7±0.4 points and 9.8±0.0 points,which were significant higher than those(9.1±0.6 points and 9.6±0.3 points)of women in the control group(P<0.05).The rates of neonatal severe asphyxia and neonatal mortality were 4.4 % and 0.0%, which were significant lower than those (19.6 and 8.70%) of women in the control group ( P <0.05). Conclusion: Systematic pre hospital first aid measures can improve the treatment success rate of emergency and critical pregnant women, can shorten the time of consultation and referral, and improve the maternal and infant outcomes.