剖宫产819例手术指征的临床分析

Cesarean section indications: A clinical analysis of 819 cases

目的探讨剖宫产指征构成比变化原因,寻求控制剖宫产率的措施。方法回顾1997年及2007年在我院行剖宫产分娩产妇的病历资料,分析手术指征构成比及剖宫产率变化。结果 1997年剖宫产率显著低于2007年,分别为34.37%和44.09%,差异有非常显著性(P<0.01)。剖宫产指征中,头位难产,臀位,妊娠并发症和胎儿宫内窘迫仍居前列,但社会因素已上升至第2位。结论社会因素是剖宫产率上升的主要因素,加强对孕产妇及家属有关分娩知识的宣教,提高医务人员的技能,严格掌握剖宫产指征是控制剖宫产率的有效措施。

Objective To investigate the changes of cesarean section indication and look for the means to decrease the cesarean section rate.Methods All the cesarean section cases in our hospital in 1997 and 2007 were retrospectively studied.Analysis was conducted as to the surgical indications,cesarean section rate as well as the change in composition.Results The cesarean section rate in 1997 was significantly lower than that in 2007（34.37% vs.44.09%,P0.01）.Dystocia,breech presentation,pregnancy complications and fetal distress were the main indications of cesarean section.Social factor was elevated to the second.Conclusion Social factor was the main cause leading to the persistent rise of cesarean section rate.In order to decrease the rate of cesarean section,we should spread the knowledge of delivery among pregnant women and their families,improve operating skills of the medical workers and strictly grasp the medical indication of cesarean section.