2013年-2018年某医院剖宫产指征变化分析

Analysis on Changes of Cesarean Section Indications of a Hospital from 2013 to 2018

目的分析近年来剖宫产率及剖宫产指征的变化趋势,为合理有效地调控剖宫产率提供科学依据。方法采用SAS9.4软件对某院2013年1月1日-2018年12月31日足月分娩产妇24701病例数据进行回顾性统计分析。结果剖宫产率呈递减趋势,全面二孩政策实施后的剖宫产率小于实施前(P<0.001)。6年间剖宫产指征中疤痕子宫占比最大(25.99%),占比最小的为双胎(0.85%)。剖宫产指征构成在政策实施后大于实施前的有疤痕子宫、胎儿窘迫和引产失败(P<0.05)。6年间剖宫产指征顺位变化中疤痕子宫始终居于前2位,顺位变化最大的是胎儿窘迫,由2013年的第8位上升到2018年的第2位;产妇要求剖宫产由2013年的第1为降低到2018年的第7位。结论临床医师应重点关注疤痕子宫、胎儿窘迫、引产失败等原因造成的剖宫产,严控剖宫产指征,降低剖宫产率。

Objectives To analyze the changing trend of cesarean section rate and indications in recent years,and provide scientific basis for rational and effective control of cesarean section rate.Methods SAS9.4 software was used to analyze the data of 24701 parturient giving birth at term from January,1 st 2013 to December,31 st 2018.Results The cesarean section rate from 2013 to 2018 showed a decreasing trend,and the cesarean section rate after the implementation of the universal two-child policy was lower than before(P<0.001).Scar uterus accounted for the largest proportion(25.99%)and the smallest proportion was twins(0.85%).The indications of cesarean section were greater after the implementation of the policy than before(P<0.05).During the 6 years,the scar uterus always ranked the top 2 in the sequence of cesarean indications,and the largest sequence change was fetal distress,which rose from the 8 th place in 2013 to the 2 nd place in 2018.The demand for cesarean section dropped from no.1 in 2013 to no.7 in 2018.Conclusions Clinicians should pay more attention to cesarean section caused by scar uterus,fetal distress and failure of induction of labor,strictly control the indications of cesarean section and reduce the rate of cesarean section.