合理掌握剖宫产指征降低围生儿死亡率

Dealing with indication of caesarean birth reasonably and reducing perinatal mortality.

目的 :探讨降低围生儿死亡率的途径 ,遏制不合理剖宫产上升趋势。方法 :回顾分析 1986年 1月至 1998年 12月 13年间 17784例产妇分娩方式变化及 2 82例围生儿死亡的临床资料。结果 :早产新生儿死亡是围生儿死亡主要原因。早产新生儿及畸形儿死亡与剖宫产率无关。与分娩方式有关的围生儿死亡率与剖宫产率负相关。绝对指征行剖宫产比例从1986年的 38 1%降至 1998年 33 0 % (P <0 .0 5 ) ,社会因素行剖宫产比例从 1986年的 2 2 %上升至 1998年的 5 4% (P <0 .0 5 )。结论 :只有提高对早产儿的诊疗水平及宫内诊疗水平 ,才能有效降低围生儿死亡率。只有通过加强医患沟通 ,合理掌握剖宫产指征 ,才能降低日趋升高的剖宫产率。

Objective:Approaching the ways to reduce the perinatal mortality.Method:Analyzing changing of the parturition from according to 17784 cases in 13years(1986.1—1998.12) and consulting the clinical data of 282 cases perinatal death. Result:The chief cause of leading perinatal infants to die is the death of premature infants.The death of premature infants and congenitally deformed infants has nothing to do with the rate of caesarean birth ,However,the death rate of perinatal infants with the relationship of parturition form has negative relation with the rate of caesarean birth The proportion of caesarean birth with the absolute indication has decreased from 38.1%(1996)to 33%(1998)(P<0.05),And the proportion of caesarean birth with the social factors has increased from 2.2%(1986) to 5.4%(1998)(P<0.05).Conclusinon: The rate of perinatal mortality can be reduced effectively only the level of diagnose and treat was raised The rate of caesarean birth rising gradually can be reduced only the understanding and communication between doctors and patients are enhanced and the indication of caesarean birth was dealt with reasonably and carefully.