剖宫产指征变化及剖宫产率升高因素的分析

Analyze of Cesarean Section Rate and Cesarean Section Indications

目的:分析6年间剖宫产率、剖宫产指征的变迁。方法:对河北省迁安市人民医院1999～2004年3638例剖宫产病例进行分析,比较剖宫产率和手术指征变化。结果:平均剖宫产率为41.94%,剖宫产率呈上升趋势。1999年为35.50%,最高2003年达49.49%,有显著性差异(P<0.01)。在剖宫产指征变化中,头盆不称逐渐下降,社会因素、胎儿窘迫逐渐上升。2002年后社会因素位居第1位。结论:剖宫产率的增加不是一个单纯的医疗问题,而是一个社会问题。加强孕产期监护和产程观察,提高医务人员及孕妇对剖宫产的认识,改变服务模式,严格掌握剖宫产指征,可有效降低剖宫产率。

Objective： To analyze mostly causes that cesarean section rate rise and changes of indications during the six years. Methods： 3 638 cesarean section cases occurred in＇ People ＂s hospital in Qianan from 1999 to 2004 were analyzed respectively. Results： The average rate of cesarean section was 41.9%, mid cesarean section rate was gradual increasing. Its rate increased obviously from 35.5 % in 1999 to 49. 5 % in 2003, and there was significant difference （P 〈0.01 ） . The changes in cesarean section indi- cations was a gradual decreasing in cephalous -pelvic disprepertion, and a gradual increasing in social factors and fetus distress. The first factor was social factors in 2002. Conclusion： The cesarean section is not an absolute safe mode of delivery. It is problem not only concerning cesarean section rate, but also about society. Reinforce the surveillance of gestation and confinement period as well as the observation of labor stage, change the concepts on cesarean section by both medical staff and women, improve obstetric services and in control of cesarean section indication might hopefully decrease the rate of cesarean section.