泰瓦共和国和阿尔泰地区早产流行病学和医疗后送细节

N. M. Hovalyg, O. V. Remneva, O. V. Kolyado
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摘要

该研究的目的是评估早产的流行病学以及2015-2019年期间在泰瓦共和国和阿勒泰地区广大地区组织农业地区患者医疗后送的措施。材料和方法。本文分析了2015-2019年泰瓦共和国和阿勒泰地区产科服务工作的统计报告数据。对早产的频率、结构、动态、组织医疗后送的特点进行了研究。使用绝对、相对和密集数据对收到的信息进行了分析。采用回归分析并计算决定系数,评价数据时间动态的统计显著性。结果。分析显示,在过去5年里,泰瓦共和国和阿勒泰地区两个幅域辽阔、不同民族的农业区的早产频率没有下降的趋势(2019年分别为6.2%和7.1%),数据与俄罗斯的平均指标(2018年为6.0%)相当。临床表型和胎龄的PB分布在研究地区没有差异,并符合全球指标。极早早产(妊娠22-27周)的比例不超过7%。与蒂瓦共和国相比,阿尔泰地区的一个显著特点是,在三级产科医院(分别为63.3%和96.8%)分娩的PB患者较少(p <0.001),这与晚期PB的频率高(53.1%)和二级医疗机构的能力充足有关。在地区医疗后送期间,β -肾上腺素能激动剂吉尼普利(95%)用于急性胎溶。结论。在梯瓦共和国组织医疗后送的特点是更频繁地使用空中救护车将病人运送到三级产科医院,其原因是,在同样的急性早产方案下,人口密度比阿勒泰领土低7倍。
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Epidemiology of premature birth and details of medical evacuation in the Tyva Republic and Altai Territory
The aim of the research is to assess the epidemiology of premature birth and measures for organizing medical evacuation of patients from agricultural regions in vast territory of the Tyva Republic and Altay Territory for the period 2015-2019. Material and methods. Th e statistical reports data on the work of obstetric service in the Tyva Republic and Altay Territory for the period 2015-2019 are analyzed. Th e frequency, structure, dynamics of premature birth, features of organizing medical evacuation have been studied. Th e analysis of the information received was carried out using absolute, relative and intensive fi gures. Th e statistical signifi cance of the temporal dynamics of data was assessed using regression analysis with calculation of determination coefficient. Results. The analysis showed that premature birth frequency in two agricultural regions with a vast territory and diff erent nationalities in the Tyva Republic and Altay Territory over the past 5 years has no tendency to decrease (2019 – 6.2 % and 7.1 %, respectively) and the data are comparable with an average Russian indicator (2018 - 6.0 %). Distribution of PB by clinical phenotype and gestational age in the studied territories does not diff er and correspond to global indicators. Th e share of very early premature births (22-27 weeks of gestation) is not more than 7 %. A distinctive feature of Altai Territory in comparison with the Tyva Republic is a rarer (p <0.001) obstetric delivery of patients with PB in obstetric hospitals, level III (63.3 % and 96.8 %, respectively), which is associated with high frequency of late PB (53.1 %) and suffi cient capacity of medical organizations, level II. During medical evacuation in the regions, beta-adrenergic agonist ginipral (95 %) was used for acute tocolysis. Conclusion. Organization of medical evacuation in the Tyva Republic is characterized by more frequent use of air ambulance for patient transportation to obstetric hospital, level III, which is explainable by 7 times lower population density compared to Altay Territory with the same schemes of acute tocolysis.
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