4146例剖宫产指征的临床分析

Analysis of operation indicators for 4 146 cases cesarean section

目的通过回顾性分析天津市塘沽区4 146例剖宫产病例,明确该地区剖宫产率及主要的手术指征,以探讨降低剖宫产率应采取的措施。方法选择2003年1月～2009年12月在天津市第五中心医院分娩者共6 923例,剖宫产为4 146例,分析剖宫产率、不同剖宫产手术指征所占构成比、7年中剖宫产手术指征构成比的动态变化等。结果 7年平均剖宫产率为59.89%,2008年最高为62.81%,2005年最低为57.18%;在影响分娩方式选择的各类因素中,胎儿窘迫、头盆因素、社会因素占前三位,分别为24.82%、24.02%、7.43%,产程异常最低,为0.84%,巨大儿占2.94%,为第11位。结论天津市塘沽区剖宫产率高于既往报道水平,影响因素主要为胎儿窘迫、头盆因素、社会因素等,严格掌握剖宫产手术指征,是降低剖宫产率重要措施。

Objective To retrospectively analyze the Tanggu district of Tianjin City in 4 146 cases of cesarean section, clear cesarean section rate and the main indication of operation of the area that reduce the rate of cesarean section, to explore the measures to be taken. Methods There were 6 923 cases of childbirth （4 146 cases of cesarean section） in the Fifth Central Hospital of Tianjin City to be selected in section rate, different indications for cesarean section occu- pies the proportion, in 7 years the indications for cesarean section rate dynamic changes. Results The average of 7 year cesarean section rate was 59.89%. The highest in 2008 （62.81%）, 2005 （57.18%） was the lowest in the influence of mode of delivery. Choice of various types of factors, fetal distress, cephalopelvic factors, social factors accounted for three, respectively 24.82%, 24.02%, 7.43%, labor abnormality minimum was 0.84%. Macrosomia accounted for 2.94%, was eleventh. Conclusion In Tanggu District of Tianjin City cesarean section rate is higher than that of previously reported levels. The main factors are fetal distress, cephalortinv and social factors. Strict control of cesarean section indications is an important measure to reduce cesarean section rate.