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目的 研究妇产科死亡规律 ,探讨降低病死率的措施。方法 以回顾性分析方法收集 44年死亡病例338例 ,按年代、产科和妇科分别统计 ,研究妇科和产科死亡例数及所占比率变化 ,妇科和产科病死率变化 ,妇科和产科死亡原因所占比率及顺位变化 ,认识妇产科疾病的死亡规律。结果 产科死亡者所占比率平均为43 4 9%,呈下降趋势 ;妇科死亡者所占比率平均为 5 6 5 1%,呈上升趋势。产科病死率在 0 19‰～ 1 96‰之间 ,平均 0 5 7‰ ,呈下降趋势 ;妇科病死率在 1 0 0‰～ 5 6 7‰之间 ,平均 2 36‰ ,呈上升趋势。产科死亡原因主要是子痫、产科出血、产科感染、羊水栓塞及其全身严重并发症 ,其中子痫、产科出血比率逐渐减少 ,产科感染近 2 0年已不复存在 ,羊水栓塞比率上升。妇科死亡原因主要是妇科恶性肿瘤 ,以绒癌、恶性葡萄胎、宫颈癌、卵巢癌、子宫体腺癌为主 ,占妇科死亡的 84 82 %(16 2 /191)。其中绒癌、恶性葡萄胎、宫颈癌比率逐渐减少 ,卵巢癌、子宫体腺癌比率相对增加。结论 加强妇女保健 ,坚持产前检查、住院分娩 ,坚持妇女定期体检和肿瘤病人随诊、追踪治疗 ,提高医疗保健人员的医疗技术水平和对急重症的诊断救治能力 ,是提高急重症抢救成功率 ,降低病死率的有效措施。
Objective To study the law of death in obstetrics and gynecology and to explore measures to reduce the mortality rate. Methods A retrospective analysis was used to collect 338 cases of 44 deaths. According to the statistics of age, obstetrics, and gynecology, the number of gynecological and obstetric deaths and changes in the proportion of gynecological and obstetric deaths, gynecological and obstetric mortality, gynecological and obstetric deaths were analyzed. Changes in the ratio and the rankings, to understand the death of obstetrics and gynecology diseases. Results The proportion of deaths among obstetricians was 43.9%, which was on the decline. The proportion of gynecological deaths was 565.1%, showing an upward trend. The obstetric mortality rate ranged from 0 19 to 1 96, with an average of 0 5 7 , , showing a decreasing trend. The morbidity rate of gynecological diseases ranged from 1 0 0 to 5 6 7 , with an average of 236 ,, showing an upward trend. The main causes of obstetric mortality are eclampsia, obstetric hemorrhage, obstetric infection, amniotic fluid embolism and severe systemic complications. Among them, the incidence of eclampsia and obstetric hemorrhage gradually decreases. Obstetric infection has disappeared in the past 20 years and the amniotic fluid embolism rate has increased. The main causes of gynecological deaths were gynecological malignancies, consisting mainly of choriocarcinoma, malignant mole, cervical cancer, ovarian cancer, and uterine adenocarcinoma, accounting for 84 82% (16 2 /191) of gynecological deaths. The rate of choriocarcinoma, malignant mole, and cervical cancer gradually decreased, and the rate of ovarian cancer and uterine body adenocarcinoma increased relatively. Conclusion Strengthening women’s health care, insisting on prenatal examinations, hospital delivery, insisting on women’s regular physical examination and follow-up treatment and follow-up treatment of cancer patients, improving the medical technology level of medical and health care personnel, and the ability to diagnose and treat acute and severe diseases is to increase the success rate of emergency treatment. , effective measures to reduce the mortality rate.