高原地区2013～2015年剖宫产指征变化的临床分析

Clinical Analysis of the Change of the Cesarean Section Indications at High Altitude in 2013 and 2015

目的：本文通过分析我院3年1240例剖宫产手术指征构成比例,探讨如何正确掌握剖宫产指征,降低剖宫产率的措施。方法：回顾分析2013年1月～2015年12月在西藏日喀则市人民医院剖宫产分娩产妇的1240例的临床资料。结果：近3年我院剖宫产率无明显上升趋势,基本稳定在20.11%～24.05%之间。胎位异常、胎儿宫内窘迫、难产、疤痕子宫、妊娠合并发（合并）症为剖宫产主要指征,社会因素所占比例远远低于平原地区。结论：积极开展产前教育、加强围产期保健、提高产前诊断率、提高阴道助产能力、正确掌握剖宫产指征、降低剖宫产率。

Objective： To investigate the ratio of indications in 1240 cesarean section cases in our hospital during the last three years and its rational application for exploring the measures of tow cesarean rate.Methods： Clinical data of 1240 patients undergoing cesarean section in our hospital from January 2013 to December 2015 were retrospectively analyzed.Results： The caesarean delivery rate generally remained at a level of between 20.11% and 24.05%, with no significant upward trend during the last three years. The main indications being related to abnormal fetal position, fetal distress, dystocia, uterine scar, and pregnancy complications. However, the proportion of social factor in Tibet was less than that in mainland.Conclusions： Carrying out prenatal education actively, strengthening the perinatal care, enhancing the rate of antenatal diagnosis, improving the ability of vagina delivery, and mastering uterine-incision delivery indication strictly in order to reduce the rate of cesarean.