某院近5年剖宫产率及社会因素剖宫产率变化分析与对策

Analysis of Changes in Rates of Cesarean Sections and Social Factors Related Cesarean Sections over the Recent 5 Years in Some Hospital and Coping Strategy

目的探讨近5年剖宫产率及社会因素剖宫产率的变化特点,提出干预措施。方法对某医院2004年1月—2008年12月14011例产妇的病例资料进行回顾性统计分析,计算剖宫产率和各项剖宫产指征所占比例。结果2004—2007年剖宫产率呈下降趋势,经比较差异有统计学意义(χ2=41.15,P<0.005),2008年剖宫产率有所回升,但与前3年比较差异无统计学意义。近5年疤痕子宫为指征的剖宫产构成比呈逐年上升的趋势;妊娠合并症和胎儿宫内窘迫为指征的剖宫产构成比近3年均较2004年有较大幅度下降;2004—2007年社会因素所致剖宫产所占比例呈上升趋势,2008年有所下降。结论积极开展孕期教育,纠正产妇及家属的认识误区,指导产妇充分试产,加强医护人员的业务学习和职业道德教育,避免对产妇的暗示和导向作用,是干预社会因素剖宫产的可行措施。

Objective To explore the changes in rates of cesarean sections and social factors related cesarean sections over the recent 5 years in some hospital, and thus formulate the coping strategy. Methods A retrospective analysis was made of the medical records of 14 011 parturients hospitalized in some hospital between Jan., 2004 and Dec., 2008. And the rate of cesarean sections and the percentage of the various indications of the cesarean section were worked out. Results From 2004 to 2007, the rate of cesarean sections showed a declining tendency, with the differences being statistically significant （χ2=41.15, P〈0.005）, while that in 2008 on the rise, with the difference from the previous three years having no statistical significance. Over the recent 5 years, the proportion of the cesarean sections with the scar uterus as the indication was on the rise year on year; that of the cesarean sections with pregnancy complications and fetal distress as the indication in the recent three years saw a sharp decline against 2004; the social factors related cesarean sections exhibited a rising tendency between 2004 and 2007, while a declining one in 2008. Conclusion Conducting education in knowledge about pregnancy so as to put right the mistaken understanding by the parturients and their dependents, guiding the parturients to have trial delivering, strengthening the professional study and education in occupational ethics to avoid suggesting to and orientating the parturients, are practicable interventions for social factors related cesarean sections.