剖宫产指征的变迁及其影响因素

Changes in Indication of Cesarean Section and Its Influencing Factors

目的:探讨剖宫产指征变迁的原因,指导临床合理掌握剖宫产指征。方法:对吉林大学第二医院产科1990、1996、2001、2005年住院分娩的5459例病例进行回顾性分析,另外以问卷形式调查100例无指征剖宫产孕产妇行剖宫产的思想因素。结果:①15年来剖宫产率、择期剖宫产率呈上升趋势。其中社会因素是近年来剖宫产率尤其是择期剖宫产率增高的主要原因。②无医学指征行剖宫产的病例增多。占前3位的思想因素为:担心不能胜任自然分娩、害怕疼痛;担心阴道分娩影响新生儿智力;胎儿较大担心母儿安全不愿试产。结论:社会因素是近年来剖宫产率增高的主要原因,其根源是人们对剖宫产的错误认识。

Objective:Objective: to remove the bad society factor,reduce cesarean section rate and guarantee the safety of mother and infant.Methods:we retrospective studied the case of delivery in our hospital in 1990、1996、2000、2005 ,and investigated main thought influence factor of 100 examples of society Cesarean section with the questionnaire .Results:(1) The cesarean rate and selective cesarean rate increased remarkable during the following 15 years. The society factor become the principle reason especially in selective Cesarean section. (2) The cases which require to proceed the section are rising,and the first three thought factors: ① Worries about vaginal delivery and afraid of pain ② Worries about the influence to neonate intelligence . ③ Worries the mother and fetal safety because of fetal macrosomia .Conclusion:the social factor is the main reason of increasing Cesarean section rate recently, whose source is the mistake understanding of Cesarean section .