危重孕产妇多学科会诊现况与策略分析
发布人：yaot 发布时间：2022/5/10 17:12:47 浏览次数：1032次
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】——姜宗杰 佟朝霞 孟黎辉
【摘要】目的 汇总分析北京市某危重孕产妇救治中心多学科会诊数据，为提升救治质量提供依据。方法 提取2017年-2020年该中心医疗工作报表及危重孕产妇多学科会诊数据，录入Excel 2017软件，运用数据透视表进行分析。结果 2017年-2020年该中心申请多学科会诊孕产妇共338例，北京地区孕产妇占比、城镇孕产妇占比、本科及以上学历孕产妇占比、月收入3 000元以上孕产妇占比整体均呈下降趋势，而危重孕产妇比例、申请会诊孕产妇平均年龄、参与会诊科室数量呈增长趋势。申请多学科会诊的孕产妇排名前5位的疾病以妊娠合并心脏病为主，排第1位的为妊娠合并肺动脉高压；参与孕产妇会诊的科室主要有麻醉科、重症医学科、心脏大血管外科、心脏内科、心内科重症监护室、普儿科。结论 危重孕产妇救治形势严峻，管理难度增加。需完善救治体系，加强闭环管理，落实风险管控，按需配置多学科救治团队。
【关键词】多学科会诊；危重孕产妇；医疗质量
中图分类号：R197.323；R714文献标识码：B
Analysis and Strategies of Multidisciplinary Consultation for Critically Ill Pregnant and Puerperal Women/JIANG Zongjie,TONG Zhaoxia,MENG Lihui.//Chinese Health Quality Management，2022,29(4):30-32,38
Abstract Objective To analyze the multidisciplinary consultation data from a critically ill pregnant and puerperal women treatment center in Beijing to provide evidence for improving treatment quality.Methods The data of medical work report and critically ill pregant and puerperal women multidisciplinary consultation were extracted from 2017 to 2020, inputed into Excel 2017 software, and analyzed by pivot table.Results From 2017 to 2020, a total of 338 cases of pregnant women applied for multidisciplinary consultation in the center. The proportion of pregnant women from Beijing area, urban pregnant women, pregnant women with a bachelor's degree or above, and pregnant women with a monthly income of more than 3 000 yuan showed a decreasing trend. The proportion of critically ill pregnant women, the average age of pregnant women applying for consultation and the number of departments participating in consultation showed an increasing trend. The top 5 diseases of pregnant women applying for multidisciplinary consultation were mainly pregnancy complicated with heart disease, and pregnancy complicated with pulmonary hypertension ranked the first. The departments involved in maternal consultation mainly included anesthesiology, intensive care, cardiovascular surgery, cardiology, cardiology intensive care unit and general pediatrics.Conclusion The situation of treatment for critically ill pregnant women is severe and the management is more difficult. It needs to improve the medical treatment system, strengthen closed-loop management, implement risk management and control, and deploy multidisciplinary medical teams as needed.
Key words Multidisciplinary Consultation; Critically Ill Pregnant and Puerperal Women; Medical Quality
Firstauthor's address Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
孕产妇死亡率是衡量一个国家或地区政治、经济、文化及卫生水平的重要指标之一［1］。《中国妇幼健康事业发展报告（2019）》［2］显示,2018年，我国孕产妇病死率下降。但受生育政策放开等因素影响，伴有合并症等的高危孕产妇增加［3］。苏虹等研究［4］表明，“二孩政策”放开后，孕产妇因主客观原因所致的妊娠合并高血压、糖尿病、心脏病及甲状腺疾病等发病率明显上升，需联合多学科救治。有研究［5］表明，多学科协作治疗能够提高危重孕产妇救治的成功率。本研究对北京市某危重孕产妇救治中心2017年-2020年危重孕产妇多学科会诊情况进行汇总，以期为提升孕产妇救治质量提供依据。
