某县级医院近7年非医学需要剖宫产原因分析与对策

The Causes of Uterine-incision Delivery for Non-medical Purposes in 7 Years in a County Hospital and the Countermeasures

目的探讨非医学需要剖宫产原因及其遏制对策。方法对某县级医院2000年1月-2006年12月12595例产妇情况进行回顾性调查分析,调查前研究者(本文3位作者)接受过剖宫产医学指征知识的培训,再查阅病案、统计报表及相关医疗护理记录资料,对剖宫产原因逐例分析确认,然后归项,有剖宫产医学指征的归于医学需要剖宫产,凡是孕足月及待产过程中无明显剖宫产医学指征的归于非医学需要剖宫产。结果近7年来该院剖宫产率、非医学需要剖宫产率及其构成比成逐年上升趋势,3项指标年度差异均具有统计学意义(χ2分别为478.61、506.32和186.82,P<0.01)。非医学需要剖宫产的原因有:社会因素(86.18%),产妇及其家属原因(81.58%),医源因素(60.24%),其他不明原因(9.79%)。结论非医学需要剖宫产增多是剖宫产率升高的根本原因。要充分认识剖宫产的利与弊,加强生殖健康宣传教育,努力降低非医学需要剖宫产率,提高母婴健康水平。

Objective To explore the causes of uterine-incision delivery for non-medical purposes as well as countermeasures. Methods After training to the three authors in this research on medical indications for uterine-incision delivery, a retrospective survey was conducted on 12 595 parturients admitted into a county hospital from Jan. 2000 to Dec. 2006, by reviewing the cases reports, report forms, and the related care records. The causes for uterine-incision delivery were verified and sorted by medical indications and non-medical indications. Results Within the 7 years, the total rate of uterine-incision delivery as well as uterine-incision deli- very rate without medical indications and its proportion escalated year by year. The differences were signiiqcant in the three items between years （χ^2=478.61,506.32 and 186.82, respectively; P〈0.01）. The causes included： social factor （86.18%）, the factors from the partufients and their families （81.58%）, factors from medical treatment（60.24%） and other unidentified factors （9.79%）. Conclusion The uterine-incision delivery for non-medical purposes gives rise to the increase of uterine-incision delivery rate. We should fully recognize the advantages and disadvantages, enhance the education of gynecological health, decrease rate of the uterine-incision delivery for non-medical purposes and finally increase the parturient and infant＇s health.