广西贫困山区新生儿窒息死亡综合干预效果的评价

目的 :了解新生儿窒息死亡综合干预的效果 ,探讨新生儿窒息群体防治工作的切入点。方法 :实施广西综合性妇幼卫生保健项目的 7个贫困山区县采取强化政府行为 ,增加资金和设备投入 ,规范妇幼卫生管理和保健服务 ,加强县乡级新生儿窒息复苏术和孕产期保健适宜技术培训 ,实行医疗扶贫救助等措施。结果 :新生儿窒息死亡率由1995年的 6 .93‰降至 2 0 0 0年的 3.5 0‰ ,降幅 49.74%;救活了 17844人窒息新生儿 ;其发生率由 12 .6 1%降至 9.37%,降低了 2 6 .19%;孕期保健率提高了 35 .70个百分点 ,住院分娩率提高了 11.0 4个百分点 ,高危住院分娩率提高 6 .18个百分点 ;Topsis法评价结果 ,2 0 0 0年新生儿窒息、孕产妇保健质量最优 ( Ci=0 .840 8) ;单因素相关分析 ,孕期保健与新生儿窒息发生高度负相关 ( r=- 0 .946 ,P<0 .0 0 5 )。结论 :实行政府领导下的综合性干预措施 ,提高孕产期保健质量 ,是新生儿窒息群体保健一级预防措施。

Evaluation on the effect of comprehensive intervene neonatal asphyxia death in impoverished mountain area of Guangxi

Object: By investigation on the effect of comprehensive intervene neonatal asphyxia death to seek a way of group prevention and treatment in neonatal asphyxia. Method: The government action was strengthened, the fund and equipments were increased, the MCH ministration and health service were standardized, the MCH staff in these counties and villages were trained about the neonatal asphyxia resuscitation and the skill of antenatal and perinatal care in the 7 impoverished mountain areas undergoing the comprehensive MCH item. Result: The neonatal asphyxia mortality has been reduced from 6 93‰ in 1995 to 3 50‰ in 2000.17 844 cases asphyxia neonates were resuscitated. The incidence rate of asphyxia neonatal has been reduced from 12 61% in 1995 to 9 37% in 2000.The antenatal care rate has been raised 35 70%. The labor rate in hospital has been raised 11.04%. The high risk labor rate in hospital has been raised 6.18%. The result of evaluation in Topsis is that the quality of neonatal asphyxia and maternal care is the best (Ci=0 840 8). The result in single factor analysis is that the relationship between antenatal care and the neonatal asphyxia is negative correlation (r=-0 946, P <0 005). Conclusion: Carrying out the comprehensive intervene measure guided by the government and raising the antenatal and perinatal care quality are the first level prevention measure for the neonatal asphyxia.