广州市荔湾区近8年剖宫产率的动态变化分析

Study on the trends of the rate of cesarean section in the last 8 years

目的:了解广州市荔湾区近8年来的剖宫产现状.方法:利用该区1995～2002年度产科质量报表和围产儿死亡评审资料,采用描述性分析和历史性队列研究,分析了近8年剖宫产率的动态变化趋势、不同级别医院剖宫产率的差异以及剖宫产与围产儿死亡的关系.结果:8年来,该区剖宫产率从34.64%上升到56.70%,市级医院剖宫产率高于区级医院(x2=241.93,P＜0.01).历史性队列研究显示,剖宫产是围产儿死亡的保护因子(RR=0.25,PAR%=-49.45%).在一定范围内,剖宫产率与围产儿死亡率呈反比,但剖宫产率超过一定范围后,围产儿死亡率有上升趋势.结论:近年来该区的剖宫产率逐年升高;合理地使用剖宫产术对降低围产儿死亡率有一定的作用,但剖宫产率的持续上升并不能带来围产儿死亡率的持续下降,因此有必要采取措施降低过高的剖宫产率.

Objective： To explore the status of cesarean section in the past 8 years in Liwan district of Guangzhou and to analyze the pros and cons about it. Methods： All data based on obstetrics quality reports and prenatal death assessment records from 1995 to 2002 in Liwan district. The trends of the rate of cesarean section, the rate of cesarean section in different rank hospital and the relation between cesarean section and perinatal mortality were investigated by descriptive study and historical cohort study. Results： The rate of cesarean section had risen from 36. 64% to 56. 70% in the past 8 years, the rate of cesarean section in city hospital was higher than that in district hospital （X^2 =241.93, P〈0. 01 ） . Conclusion： In recent years, the cesarean section rate was rising year by year. In certain extent, making good using of the cesarean section was helpful to reduce the perinatal mortality. But keeping on rising the cesarean section rate couldnt continued reducing the perinatal mortality. It was necessary to prevent a further increase in the rate of cesarean section.