2010—2013年湛江市妇幼保健院剖宫产率高的临床原因分析

Clinical Analysis on Clinical Causes of the Increase of Cesarean Section Rate in Zhanjiang from 2010 to 2013

目的探讨剖宫产率增高的临床原因,为合理控制剖宫产率提供临床依据。方法对我院2010—2013年4年间剖宫产情况进行回顾性分析,对不同年度剖宫产率、新生儿并发症发生情况进行比较,找出剖宫产率增高的主要原因。采用统计学t检验、χ2检验进行显著性判断。结果剖宫产率为35.20%,比2010年前增加了34%,剖宫产率呈逐年升高趋势;剖宫产率逐年升高,但新生儿并发症发生率无统计学意义;剖宫产率高的首位原因是社会因素,占35.35%;剖宫产与阴道分娩新生儿并发症发生率无明显差别(P>0.05)。结论剖宫产手术是处理难产、胎儿危机,抢救母婴生命的有效手段。但过高的剖宫产率并没有降低新生儿并发症的发生率,关键是社会因素的干扰,必须转变观念,正确认识分娩过程和手术产的利弊,正确处理产程,合理掌握剖宫产医学指征,才能有效降低剖宫产率,保障母婴健康和安全。

OBJECTIVE To investigate the clinical factors of high cesarean section rate,to provide clinical basis for the reasonable con-trol of the rate of cesarean section. METHODS In target hospital, four years of cesarean section were analyzed retrospectively,in dif-ferent years of neonatal cesarean section,compare the incidence and find out the main reason for the increase of cesarean sectionrate. The results of t test,χ^2test for significant judgment. RESULTS The cesarean section rate was 35.20%;34% more than fouryears ago,the rate of cesarean section increased;cesarean section rate increased year by year,but the incidence rate of neonatalcomplications had no significant difference;the first reason was the social factors of cesarean section,accounting for 35.35%;cesar-ean section and vaginal delivery neonatal complications there was no significant difference（P〉0.05）. CONCLUSION The cesarean sec-tion operation was the treatment of dystocia,fetal crisis,effective means to save the mother＇s life,but the high rate of cesarean sec-tion did not reduce the incidence of neonatal complications,the key was to disrupt social and human factors,must change the idea,correct understanding of the delivery process and the operation of the pros and cons,correctly handle the production process,a rea-sonable grasp cesarean section of medical indications, could effectively reduce the rate of cesarean section, maternal and childhealth protection and safety.