基层医院1041例剖宫产病例临床分析

Clinical analysis on 1041 cases of cesarean section in primary hospital

目的:了解剖宫产术在基层医院的开展情况及存在的问题。方法:对2008年海南省3家中心卫生院的1 041例剖宫产病例进行整理,综合分析其剖宫产比率、手术指征、术式选择、再次剖宫产手术情况。结果:总剖宫产率为39.12%。以疤痕子宫和社会因素为剖宫产指征的分别占23.63%和11.82%,居前5位;下腹横切口剖宫产术占总剖宫产手术的93.08%;二次剖宫产从开腹至胎儿娩出的平均时间及手术平均时间均长于一次剖宫产;有一次剖宫产史者再次剖宫产率为95.18%,有二次剖宫产史者的剖宫产率为100%,阴道分娩率为4.82%。结论:社会因素是剖宫产率升高的主要原因。

Objective：To understand the application condition and problems of cesarean section in primary hospital.Methods：The clinical data of 1 041 cases of cesarean section in 3 health centers of Hainan in 2008 were arranged,the conditions of ratio of cesarean section,operative indications,selection of operation modes and repeated cesarean section were analyzed.Results：The total rate of cesarean section was 39.12%.The proportions of scar uterus and social factors among indications of cesarean section were 23.63% and 11.82%,respectively,ranking the first five;lower abdominal transverse incision cesarean section accounted for 93.08% in total cesarean section;the average time from operation to delivery and the average operation time in repeated cesarean section group were significantly longer than those in first cesarean section group;the rate of repeated cesarean section was 95.18% in cases with history of cesarean section once,the rate of cesarean section was 100% in cases with history of cesarean section twice,the rate of vaginal delivery was 4.82%.Conclusion：Social factors are the main causes of cesarean section.