【摘要】 目的:探索符合区二级医院实际的产科急救运作管理模式。方法:设定产科急救中心纳入标准,2010年7月~2011年11月符合纳入标准的孕产妇设为对照组,2011年12月~2013年7月符合纳入标准进入产科急救中心统一管理的孕产妇为实验组。对比两组新生儿窒息率、围产儿死亡率、孕周<34周治疗性早产发生率、剖宫产术后出血量、出血率、子宫切除率及输注红细胞悬液量。结果:观察组的新生儿窒息率、围产儿死亡率、孕周<34周治疗性早产发生率、产后出血量、产后出血率及输注红细胞悬液量低于对照组(P<0.05)。结论:开设产科急救中心,建立切合区二级医院实际的产科急救运作管理模式,制订产科急救中心入室、转诊标准,加强剖宫产术后监护,减少产后出血量及产后出血率;完善孕产妇重症监护网络,加强高危妊娠管理,积极干预降低高危因素,健全三级转诊网络,开辟产科急救"绿色"通道,减少妊娠不良结局,改善母婴预后。更多还原

【Abstract】 Objective: To explore an obstetric emergency running and management mode appropriate for secondary hospitals. Methods: An inclusion criteria for obstetrics emergency centre was set. Pregnant women meeting the inclusion criteria from July 2010 to November 2011 were taken as the control group and those meeting the criteria and admitted to obstetric emergency centre from December 2011 to July 2013 were taken as the experiment group. Rates of neonatal asphyxia,perinatal mortality,therapeutic preterm birth before 34 weeks, postcesarean hemorrhage, amount of postpartum hemorrhage and amount of red blood cell transfusion were compared. Results: The rates of neonatal asphyxia,perinatal mortality,therapeutic preterm birth before 34 weeks,postcesarean hemorrhage,amount of postpartum hemorrhage and amount of red blood cell transfusion of experiment group were lower than those of control group. Conclusion: To set up an obstetric emergency centre,establish a running and management mode for obstetric emergency appropriate for county- level secondary hospitals and set criteria for admission to the centre and referral can reinforce postcesarean monitoring and reduce the amount and rate of postpartum hemorrhage. It is essential to consummate the intensive care net,improve the high- risk pregnancy management,make active intervention to reduce high- risk factors,improve tertiary referral network,open green channel for obstetric emergency and promote multidisciplinary team cooperation. The rescue success rate can reach 100%,adverse pregnancy outcomes are reduced and maternal and neonatal prognosis are improved.更多还原