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——覃爱开 潘石蕾 罗锦兰 陈高文 杨琼辉 姚瑶
【摘要】目的降低经产妇急产发生率。方法成立品管圈小组，通过现状调查、原因解析，明确4项真因，广泛拟定对策，包括落实子宫收缩力管控措施、实施急危重症救治保障培训、建立头盆评估方案、构建产时母婴管理模式等。结果经产妇急产发生率由11.72%降至4.06%。结论品管圈活动开展可有效降低经产妇急产发生率，规范急诊分娩流程，减少并发症发生，践行优质助产服务理念，值得推广。
【关键词】品管圈；经产妇；急产；发生率
中图分类号：R197.3文献标识码：B
Reducing the Incidence of Maternal Emergency/QIN Aikai,PAN Shilei,LUO Jinlan,et al.//Chinese Health Quality Management，2019,26(3):98-101
AbstractObjective To reduce the incidence of maternal emergency.MethodsThe quality control circle group was established. Through the investigation of the current situation and the analysis of the causes, four true causes were identified, and countermeasures were widely formulated, including the implementation of uterine contractility control measures, the implementation of emergency critical care support training, the establishment of head basin evaluation program, and construction of a maternal mother infant management mode.ResultsThe incidence of maternal emergency was reduced from 11.72% to 4.06%.Conclusion The development of quality control circle activities can effectively reduce the incidence of maternal emergency, standardize the emergency delivery process, reduce complications, and practice the concept of high-quality delivery service, which is worth promoting.
Key wordsQuality Control Circle; Matemal Woman; Emergency Delivery; Incidence
Firstauthor's addressZhujiang Hospital,Southern Medical University, Guangzhou, Guangdong,510282, China
1主题选定
全体圈员从领导重视程度、重要性、圈能力、本期达成性4个维度，采用5-3-1评分法对所有备选主题进行评价，依据得分顺位确定本期活动主题为：降低经产妇急产发生率。
名词定义：妊娠 28 周以后分娩过一次，再次怀孕后要分娩称为经产妇。急产指产妇临产后子宫收缩力过强、过频（10min内宫缩≥5 次，宫腔压力≥60mmHg），分娩在短时间内结束，总产程＜3h［1］。
衡量指标：经产妇急产发生率=同一时期内经产妇急产发生例数÷同一时期内经产妇阴道分娩例数×100%。
选题背景：急产是产科质量控制的关键指标之一。随着二孩政策的放开，越来越多的经产妇来院分娩。调查表明，2017年1月-10月医院共接收717例阴道分娩经产妇，有84例发生急产，急产发生率为11.72%。有研究显示，急产可导致产妇和新生儿产伤率增加，新生儿窒息、软产道裂伤、产后出血、新生儿头颅血肿、产道感染率等是急产常见并发症［2-4］。控制急产发生率，不仅有利于规范急产分娩流程，图2子宫收缩过强的原因分析图3宫颈成熟度评分误差的原因分析减少母婴并发症发生，缩短患者住院天数，而且有助于加强医护合作，践行优质助产服务理念，提高患者满意度。
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