太原市迎泽区不同等级医院剖宫产率及剖宫产指征的分析

Analysis on cesarean section rate and indications in hospitals at different levels in Yingze district of Taiyuan city

目的:分析太原市迎泽区不同等级医院的剖宫产率、剖宫产指征及其相关性,探讨有效降低剖宫产率的措施。方法:回顾性分析2012年山西医科大学第一附属医院(A组)、太原市妇幼保健院(B组)、迎泽区产科医院(C组)、迎泽区郝庄镇卫生院(D组)及现代妇产医院(E组)住院分娩的7 066例临床资料。结果:A组剖宫产率为43.53%,B组为38.65%,C组为50.18%,D组剖宫产率为12.72%,E组为63.72%,五组剖宫产率差异无统计学意义(P>0.05)。A组剖宫产妇首位剖宫产指征为妊娠并发症及合并症,B组和D组的首位剖宫指征为瘢痕子宫,C组和E组剖宫产妇首位剖宫产指征为社会因素。妊娠并发症及合并症是A组的首位剖宫产指征,与其他四组相比差异有统计学意义(P<0.01)。结论:太原市迎泽区的剖宫产率趋于国家平均水平,与等级无相关性。剖宫产率的上升与诸多因素有关,只有通过医患双方和全社会的共同努力,合理掌握剖宫产指征,才能有效降低剖宫产率。

Objective： To analyze the cesarean section rate, indications and their correlation in hospitals at different levels in Yingze district of Taiyuan city, explore effective measures to reduce cesarean section rate. Methods： The clinical data of 7 066 pregnant women who gave birth to their babies in the First Affiliated Hospital of Shanxi Medical University （ group A） , Maternal and Child Health Care Hospital of Taiyuan City （ group B ）, Maternity Hospital of Yiugze District （ group C ）, Hao Town Health Center of Yingze District （group D） and Modem Obstetrics and Gynecology Hospital （group E） in 2012 were analyzed retrospectively. Results： The rates of cesarean section in group A, group B, group C, group D and group E were 43.53%, 38.65%, 50. 18%, 12.72% and 63.72%, respectively, there was no statistically significant difference among the five groups （ P 〉 0. 05 ） . The top one indication of cesarean section in group A was preg- nancy complication; in group B and group D, the top one indication of cesarean section was scar uterus; while in group C and group E, the top one indication of cesarean section was social factor. Pregnancy complication was the top one indication of cesarean section in group A, compared with the other four groups, there was statistically significant difference （ P 〈 0. 01 ） . Conclusion： The cesarean section rate in Yingze district of Taiyuan city is consistent with the national average level. It is not correlated with the levels of hospitals. The increase of ce- sarean section rate is related to many factors. Only mastering the indications of cesarean section reasonably with the efforts from doctors, pa- tients and the whole society, the rate of cesarean section can be reduced effectively.