RESUMEN
Objective:To analyze the trend of maternal mortality ratio (MMR) and death causes in Tianjin from 2011 to 2020 and to guide the management of maternal health.Methods:All the reviews data of 89 maternal death cases in Tianjin from 2011 to 2020 were retrospectively collected to analyze the trend of MMR, rank order of death causes, and death review results using Chi-square test. Results:(1) The average MMR in Tianjin was 7.97/100 000 during the study period, showing an overall fluctuating decline. The highest MMR was 12.61/100 000 in 2014 and the lowest was 3.85/100 000 in 2019. (2) Among the dead pregnant women and parturients, non-registered residents had higher proportion of women with advanced age, no steady occupation/unemployment, below junior college education, multipara, or without maternal health manual compared with the registered residents [33.33% (8/24) vs 20.00% (13/65), χ2=46.18; 100.00%(24/24) vs 69.23%(45/65), χ2=9.53; 87.50% (21/24) vs 64.62% (42/65), χ2=4.44; 79.17% (19/24) vs 44.62% (29/65), χ2=8.42; 75.00%(18/24) vs 13.85% (9/65), χ2=31.02; all P<0.05]. (3) Direct obstetric factors and indirect factors that caused death were accounted for 57.30% (51/89) and 42.70% (38/89). The top five death causes were postpartum hemorrhage, hypertensive disease during pregnancy, sudden death, venous thrombosis and pulmonary embolism, and amniotic fluid embolism. (4) In terms of the maternal death review results, 39.33% (35/89) of maternal deaths were avoidable, among which 94.29% (33/35) were caused by direct obstetric factors and 5.71% (2/35) were indirect. (5) The main influencing factors of avoidable death causes were knowledge and skills inadequacy in the health care system (62.86%, 22/35), of which 86.36% (19/22) happened in health facilities at and below the district/county level. Conclusion:It is suggested to strengthen the medical care of health facilities at and below the district/county level and the maternal health management of the non-permanent residents to ensure maternal and infant safety and to further reduce the MMR.
RESUMEN
@#ObjectiveTo study the effect of menbranous milkvetch root parenteral solution on insulin resistance of gerontism cerebral infarction in recovery stage.Methods66 patients with gerontism cerebral infarction were randomly divided into therapy group(33 cases) which received membranous milkvetch root parenteral solution and control group(33 cases).Both groups adopted routine treatment at the same time, the period was 20 days. Insulin(Ins), free blood sugar(FBS), total cholesterol(CH), triglyceride(TG), hemorheology and insulin resistance(indicating by index of insulin sensitive) of blood on empty stomach were evalutated before and after treatment. ResultsAfter treatment there was decrease in CH, FBS, FINS in therapy group than in control group(P<0.01 or P<0.05); the clinical effect in therapy group was better than in control group(P<0.01).ConclusionMembranous milkvetch root parenteral solution can significantly decrease insulin resistance, blood lipin, blood viscosity in recovery stage of gerontism cerebral infarction, and improve clinical efficiency.