10年间剖宫产率及指征变化与围生儿死亡率的关系

Relationship between cesarean section rate and changes of cesarean section indication and perinatal mortality

目的 探讨剖宫产率及剖宫产指征变迁对围生儿死亡率的影响。方法 对 10年间剖宫产病例资料进行回顾性分析。结果 1992～ 1996年剖宫产率为 3 6 5 0 % ,显著低于 1997～ 2 0 0 1年的 47 78% ,两者比较 ,差异有极显著性 (P <0 0 1)。在剖宫产指征中 ,妊娠并发 (合并 )症始终处于第 1位 ,社会因素上升为第 2位 ,难产为第 3位 ,胎儿窘迫为第 4位。围生儿死亡率 1992～ 1996年为 17 88‰ ,1997～ 2 0 0 1年为 2 2 2 3‰ ,两者比较 ,差异无显著性 (P >0 0 5 )。结论 剖宫产率升高在一定范围内降低了围生儿死亡率 ,但随着剖宫产率的进一步升高 ,围生儿死亡率并未随之下降。因此 ,应合理掌握剖宫产指征 。

Objective To study the effects of cesarean section rate and changes of cesarean section indication on the perinatal mortality rate.Methods 4945 cesarean section cases occurred in our hospital from Jan 1992 to Dec 2001 were analyzed retrospectively.Results The cesarean section rate in 1992～1996 was 36 50%,which was significantly lower than that of 47 78% in 1997～2001 (P<0 01).In the cesarean section indications,complication of pregnancy was always the first,social factor rises to the second,dystocia was the third and fetal distress was the fourth.There was no significant difference in the perinatal mortality rate (P>0 05).Conclusion Within certain limits,the rise in cesarean section rate can reduce perinatal mortality rate.But with the further rise of cesarean section rate,the perinatal mortality rate does not decrease.Therefore,we should have a grasp of cesarean section indication to decrease cesarean section rate.