剖宫产率及剖宫产指征5年变化分析

Analysis on Changes of Cesarean Section Rate and Caesarean Section Indication During a Five-year Period

目的分析剖宫产率及剖宫产指征的变化,寻求降低剖宫产率的措施。方法回顾旅顺口区2004年10月1日-2008年10月31日剖宫产分娩病历3 759例,分析5年间剖宫产率、剖宫产指征的变化,以及和围生儿病死率的关系。结果①各年度剖宫产率呈逐年上升,远远高于WHO规定的15%[1]以下;②剖宫产指征的变化中,难产因素、胎儿窘迫持续在第1、2位,社会因素由2004年的第7位上升至第3位,是剖宫产率上升的关键原因;③5年来围生儿病死率趋于稳定,并未因剖产率的上升而下降。结论提高人口综合素质,减少社会因素和精神因素导致的剖宫产,科学合理选择分娩方式是降低剖宫产率的关键。

Objective To analyze the variation of cesarean section （CS） rate and CS indication, and to look for the measures to lower CS rate. Methods We reviewed 3,759 cases of CS which came from Lushunkou District from Oct. 1, 2004 to Oct. 31, 2008, then analyzed the variation of CS rate and CS indication and their relationships with the perinatal mortality during a five- year period. Results The CS rate showed an increasing trend year by year, which was much higher than 15 % set by WHO. The CS indications were as followed： dystocia, fetal distress, and social factors which went up to the third place from the seventh place in 2004, and these were the main reasons for the increase of the CS rate. The perinatal mortality remained stable during the five - year period, which did not decline with the rise of the CS rate. Conclusions The results suggest that the CS rate can be reduced by enhancing people＇s comprehensive quality, decreasing CS caused by social and psychic factors, and selecting the way of delivery scientifically and rationally.