循證制定災后孕婦醫療保健及醫療救助模式初探_《中國循證醫學雜志》

作者：

傅璟 , 胡麗娜 , 許良智 , 周容 , 王和

四川大學華西第二醫院婦產科（成都 610041）;

關鍵詞：

災后醫療救助孕婦醫療保健循證決策

DOI：

10.7507/1672-2531.20080157

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　循證評價世界范圍內的災后孕婦醫療保健措施及醫療救助模式，為進一步完善我國災后孕婦管理措施提供決策依據。
方法　檢索 Cochrane 圖書館（2008 年第 2 期）、MEDLINE 光盤數據庫（1966 ～ 2008.6）、EMbase 數據庫（1984 ～ 2008.6）、維普中文科技期刊數據庫（1989 ～ 2008 年 6 月）、中國生物醫學文獻光盤數據庫（1978 ～ 2008.6）、萬方數據庫（1997 ～ 2008.6）、中國學術期刊全文數據庫（1994 ～ 2008.6），手工檢索《中華婦產科雜志》等雜志，篩選截至 2008 年 6 月 20 日的關于災后孕婦醫療保健的文獻和指南，評定文獻質量，并進行綜分析。
結果　初檢出文獻 293 篇，按照納入與排除標準，最終納入 25 篇，其中指南 5 篇，主要涉及災后妊娠結局、胎兒生長發育和孕婦外傷急救三方面。綜合數據庫文獻及官方網站信息發現，現有文獻以回顧性分析和隊列研究為主，與災難相關的孕婦醫療保健研究較少，尚無災后孕產婦急救流程的相關指南，這與災難的突發性、罕見性和復雜性相關。
結論　災后孕婦醫療保健及醫療救助是一個系統工程，需要國家綜合考慮孕婦需求、疾病負擔等因素，統籌規劃、總體設計。

引用本文： 傅璟,胡麗娜,許良智,周容,王和. 循證制定災后孕婦醫療保健及醫療救助模式初探. 中國循證醫學雜志, 2008, 08(9): 698-702. doi: 10.7507/1672-2531.20080157 復制

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15.	Landrigan PJ, Forman J, Galvez M, et al. Impact of september 11 World Trade Center disaster on children and pregnant women. Mount Sinai Journal of Medicine, 2008, 75(2): 129-134.
16.	Rubacka JM, Schmeidler J, Nomura Y, et al. The relationship between PTSD arousal symptoms and depression among mothers exposed to the World Trade Center attacks. Journal of Nervous & Mental Disease, 2008, 196(6): 504-507.
17.	Selten JP, Yolanda van der G, van Duursen R, et al. Kahn. Psychotic illness after prenatal exposure to the 1953 Dutch Flood Disaster. Schizophrenia Research, 1999, 35: 243-245.
18.	Thul itha WKA. Family context of mental health risk in Tsunami affected mothers: findings from a pilot study in Sri Lanka. Social Science & Medicine, 2008, 66(4): 994-1007.
19.	Weissman A, Siegler E, Neiger R, et al. The influence of increased seismic activity on pregnancy outcome. Eur J Obstet Gynecol Reprod.
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23.	Sugrue M, Kolkman KA. Trauma During Pregnancy. Aust J Rural Health, 1999, 7: 82-84.
24.	Udo RV. Trauma in pregnancy. Arch Gynecol Obstet, 2007, 276: 101-117.
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26.	Warner MW, Salfinger SG. Management of trauma during pregnancy. ANZ J Surg, 2004, 74: 125-128.

1. Biol, 1989, 31(3): 233-236.
2. WHO. Reproductive health during conflict and displacement: a guide for programme managers. 2000.
3. United Nations High Commissioner for Refugees. Reproductive health in refugee situations. 1999.
4. United Nations High Commissioner for Refugees. UNHCR Handbook for the Protection of Women and Girls. 2008.
5. Atlanta GA. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Coordinating Center for Health Promotion, Centers for Disease Control and Prevention, Department of Health and Human Services. Reproductive Health Assessment Toolkit for Confl ict-Affected Women. 2007.
6. Cooperative for Assistance and Rel ief. Everywhere Raising Awareness for Reproductive Health In Complex Emergencies: A Training Manual. 2002.
7. Ewing B, Buchholtz S, Rotanz R. Assisting pregnant women to prepare for disaster.The American Journal of Maternal Child Nursing, 2008, 2: 98-103.
8. Glynn LM, Wadfwa PD. When stress happens matters effects of earthquake timing on stress responsivity in pregnancy. Am J Obstetric Gynecology, 2001, 184: 637-642.
9. Chang HL, Chang TC, Lin TY, et al. Psychiatric morbidity and pregnancy outcome in a disaster area of Taiwan 921 earthquake. Psychiatry Clin Neurosci, 2002, 56(2): 139-144.
10. Engel SM, Berkowitz GS, Wolff MS, et al. Psychological trauma associated with the World Trade Center attacks and its effect on pregnancy outcome. Paediatric and Perinatal Epidemiology, 2005, 19(5): 334-341.
11. Laplante DP, Barr RG, Brunet A, et al. Stress during pregnancy affects general intellectual and language functioning in human toddlers. Pediatr Res, 2004, 56(3): 400-410.
12. Brand SR, Engel SM, Canfield RL, et al. The Effect of Maternal PTSD Following in Utero Trauma Exposure on Behavior and Temperament in the 9-Month-Old Infant. Annals of the New York Academy of Sciences, 2006, 1071(1): 454-458.
13. Lederman SA, Rauh V, Weiss L, et al. The Effects of the World Trade Center Event on Birth Outcomes among Term Del iveries at Three Lower Manhattan Hospitals. Health Perspect, 2004, 112: 1772-1778.
14. Renuka J, Aberra B, Piyasena CL, et al. Assessment of nutritional status of children under five years of age, pregnant women, and lactating women living in relief camps after the tsunami in Sri Lanka. Food & Nutrition Bulletin, 2006, 27(2): 144-152.
15. Landrigan PJ, Forman J, Galvez M, et al. Impact of september 11 World Trade Center disaster on children and pregnant women. Mount Sinai Journal of Medicine, 2008, 75(2): 129-134.
16. Rubacka JM, Schmeidler J, Nomura Y, et al. The relationship between PTSD arousal symptoms and depression among mothers exposed to the World Trade Center attacks. Journal of Nervous & Mental Disease, 2008, 196(6): 504-507.
17. Selten JP, Yolanda van der G, van Duursen R, et al. Kahn. Psychotic illness after prenatal exposure to the 1953 Dutch Flood Disaster. Schizophrenia Research, 1999, 35: 243-245.
18. Thul itha WKA. Family context of mental health risk in Tsunami affected mothers: findings from a pilot study in Sri Lanka. Social Science & Medicine, 2008, 66(4): 994-1007.
19. Weissman A, Siegler E, Neiger R, et al. The influence of increased seismic activity on pregnancy outcome. Eur J Obstet Gynecol Reprod.
20. Rudlo VU. Trauma in pregnancy. Arch Gynecol Obstet, 2007, 276: 101-117.
21. Scorpio R, Esposito T, Smith G, et al. Blunt trauma during pregnancy: factors aVecting fetal outcome. J Trauma, 1992, 32: 213-216.
22. Kady DE. Perinatal Outcomes of Traumatic Injuries During Pregnancy. Clinical Obstetrics and Gynecology, 2008, 50(3): 582-591.
23. Sugrue M, Kolkman KA. Trauma During Pregnancy. Aust J Rural Health, 1999, 7: 82-84.
24. Udo RV. Trauma in pregnancy. Arch Gynecol Obstet, 2007, 276: 101-117.
25. Chames M, Pearlman M. Trauma During Pregnancy: Outcomes and Clinical Management. Clinical Obstetrics & Gynecology, 2008, 51(2): 398-408.
26. Warner MW, Salfinger SG. Management of trauma during pregnancy. ANZ J Surg, 2004, 74: 125-128.

《中國循證醫學雜志》

循證制定災后孕婦醫療保健及醫療救助模式初探

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《中國循證醫學雜志》

循證制定災后孕婦醫療保健及醫療救助模式初探

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