从部分贫困县住院分娩资料分析看农村地区围产保健对策

利用１９９６年在四川省和陕西省４个卫－Ⅵ项目县县乡两级医院，采用前瞻性研究方法收集的住院分娩资料，着重分析了产科床位使用率、产科接生工作负荷、产妇住院天数、剖腹产比例。结果显示：产科床位使用率不高，绝大多数医院都有５０％以上的产科床位日没有利用；接生工作负荷亦不高，各医院从事接生人员的１周平均接生数在０．５￣２．６之间；在一些乡卫生院产妇住院时间短，５０％以上的产妇住院不满１天；陕西的两县剖腹产比

Strategies on Perinatal Health Cares in Rural Areas:Basing on an Analysis to the Data of Deliveries in Hospitals in Four Poor Counties of China

Basing on data obtained prospectively on admissions to the midwifery services in County General Hospitals, Maternal and Child Health Stations, Central Township Hospitals and Regular Township Hospitals in four poor counties of Sichuan Province and Shanxi Province, the study analyzed bed occupancy rates, midwifery service load, average days in hospital for delivered mothers and proportion of ce-sarean sections in obstetrical departments of these hospitals. The results showed that these obstetrical departments were not fully utilized. In each studied hospital the obstetric bed occupancy rate did not reach 50% except one county general hospital) the average number of deliveries a week per midwife of doctor was only 0. 5-2. 6. The result also revealed in some township hospitals mothers stayed a few hours in hospitals after delivery. In two counties from Shanxi Province the proportion of cesarean section was relatively low; the proportions of cesarean section ranged from 3% to 9% in three hospitals of county level and there was almost no cesarean section conduction in township hospitals. The results suggest the strategies of perinatal health cares in rural areas as the followings; (1) the further work should focus on increasing the utilization of women for obstetrical services rather than extending obstetric beds or personnel j (2)part of obstetric personnel should go out of the hospitals to provide services of disseminate health care knowledge; (3) postpartum visit skill should be emphasized when training village midwife; (4) in some areas the correct knowledge on the conduction of cesarean section should be given to villagers and cesarean section skill and indication should be trained to obstetric doctors.