孕产妇危重症评审方法干预效果研究

目的探讨孕产妇危重症评审方法在改善产科服务质量,减少医院内孕产妇危重症的发生和减少孕产妇死亡的效果。方法 2006-2007年在河南某县和重庆某县医疗机构开展了为期两年的干预研究。干预组使用孕产妇危重症评审方法,对照组不使用该方法。干预前后两组均采用同一调查表对孕产妇危重症病例进行回顾性调查,以评估评审效果。结果干预组孕产妇危重症例数与死亡数之比由干预前的76：1上升到干预后的196：1,孕产妇死亡指数也由干预前的0.026下降到干预后的0.010;干预组的孕产妇危重症发生率从干预前的21.2‰下降到干预后的18.0‰,而对照组从16.0‰上升到22.2‰;干预组各类孕产妇危重症的规范化处理满分率在评审后均有显著上升。结论孕产妇危重症评审方法可以改善产科质量,减少孕产妇危重症发生,有必要进一步推广。

Evaluating the effectiveness of severe obstetric complications audit

【Objective】To explore the effectiveness of severe obstetric complications audit on improving the quality of obstetric care,minimizing the incidence of severe obstetric complications in the hospital,and reducing maternal mortality.【Methods】A two-year intervention study was conducted in two healthcare facilities in Henan Province and Chongqing between 2006 and 2007.During the study,the experimental group adopted the method of severe obstetric complications audit while the control group did not.Both groups conducted the retrospective investigation of severe cases via an identical survey form before and after the intervention,so as to evaluate the effectiveness of the audit.【Resluts】In the intervention group,maternal near miss mortality ratio raised from 76：1 to 196：1 and the maternal mortality index dropped from 0.026 to 0.010.The incidence of severe obstetric complications decreased from 21.2‰ to 18.0‰ in the intervention group,while increased from 16.0‰ to 22.2‰ in the control group.Meanwhile,in the intervention group,the full-score rate of standard care for all types of severe obstetric complications has increased significantly after the audit.【Conclusion】Severe obstetric complications audit can improve the quality of obstetric care and minimize the incidence of severe obstetric complications.Therefore it needs further promotion.