高危妊娠程序化管理的应用研究

目的:探讨高危妊娠的程序化管理模式,提高高危妊娠筛出率和干预率,以降低孕产妇、新生儿及5岁以下儿童的死亡率。方法:建立高危妊娠组织管理网络、制定高危妊娠筛查的评分标准、完善高危妊娠管理的工作流程。应用SPSS12.0统计软件,经Chi-Square Test分析,了解高危妊娠的程序化管理实施前后3年的高危孕产妇筛出率、孕产妇保健数、孕产妇死亡率、新生儿死亡率等情况。结果:高危妊娠的程序化管理实施前后3年高危孕产妇筛出率、孕产妇保健数、孕产妇死亡率、新生儿死亡率、新生儿死亡数占5岁以下儿童死亡的构成比比较,差异有统计学意义(P<0.05)。经Fisher’sExactTest分析,项目实施后宁阳县与同级县市的孕产妇死亡率相比具有统计学差异;与全省孕产妇的死亡率相比具有统计学差异;2006年与全国农村的孕产妇死亡率相比具有统计学差异。结论:高危妊娠的程序化管理实施后,妇幼保健服务水平不断提高,高危妊娠筛出率逐年提高,孕产妇死亡率显著降低,新生儿死亡率、新生儿死亡占5岁以下儿童死亡构成比逐年下降。

Application research on programmable management of high-risk pregnancy

Objective: To explore the programmable management models of high-risk pregnancy, increase the screening rate and intervention rate of high-risk pregnancy, thus reduce the mortality of pregnant and lying-in women, neonates and children under-five years old. Methods: The network of high-risk pregnancy management was established and screening criteria of high-risk pregnancy was instituted, the procedure of high-risk pregnancy nmnagement was perfected. Results: There was significant difference in detection rate of high-risk pregnancy, the amount of health care, maternal mortality, neonatal mortality and the percentage of neonatal mortality accounting for children mortality under five years old before and after programmable management of high-risk pregnancy (P <0. 05) . By Fisher's Ex-act test, there was significant difference in maternal mortality between Ningyang County after programmable management and the other identi-cal cities, the other cities in Shandong province; In 2006, there was significant difference in maternal mortality between Ningyang County and the other rural areas. Conclusion: After the implementation of high-risk pregnancy programmable management, the maternal and child health care services have uninterrupted improved, and screening rate of high-risk pregnancy has increased year by year, a significant reduc-tion in maternal mortality, neonatal mortality, the percentage of neonatal mortality accounting for children mortality under five years old is in decline.