四川省农村产后出血死亡影响因素调查

本文报导了四川省仪陇、阆中两县１９９０～１９９２年产后出血死亡的影响因素。研究采用１：１配对，死亡组全部为产后出血致死者，对照组为死者同村邻村前后一个月以内正常分娩存活者。事先设计好问卷、由专门培训的调查员进行调查。产后出血死亡８３例，占两县三年孕产妇死亡１３１例的６３．３６％，居各因素首位。死亡组平均出血１５５９．５±５８３．２ｍｌ，对照组平均出血为２５４．３±２４３．５ｍｌ，Ｐ＜０．００５。产后出血的原因包括胎盘因素（４９例），宫缩乏力（１８例），产道撕伤（９例），不详（７例）．死亡组与对照组比较，文化程度低等１６项影响因素有显著差异。提出减少产后出血死亡的关键在于提高乡级保健人员素质，加强围产保健和宣传，提倡在乡级以上医院分娩。

A INVESTIGATION ON AFFECTERS OF POSTPARTUM HAEMORRHAGE IN COUNTRYSIDE OF SICHUAN

This is a study which investigated the affecters of death due to postpartum haemorrhage in countryside (Yi Long and Lang Zhong countries of Sichuan from 1990 to 1992). The study design was a one to one case -control study conducted by trained interviewers with structured questionnaire. The cases were all death women who died of postpartum haemorrhage,the controls were the woman who lived in the same village of cases and had a normal delivery within one month with cases. The total number of death due to postpartum haemorrhage is 83 which accounted for 63. 36% of all pregnant death in these two counties from 1990 to 1992 and was the main cause of pregnant death. The average haemorrhage amount were 1559. 5 + 583. 2ml and 254. 3 + 341. 5ml in case and control group respectively, p<0. 005. The causes of postpartum haemorrhage included placenta factor (49 cases), inertia of uterus (18 cases),injury of birth canai (9 cases), unidendtified (7 cases). In analysis factor, the case and control was compared. According to the results,the key to reduce postpartum haemorrhage death is to improve the quality of health-care assistant in country,strengthen health service and propaganda ,encourage delivery at township hospitals or higher level hospitals.