10年间剖宫产率及剖宫产指征变化分析

Analysis of cesarean section rate and changes of cesarean section indication

目的 :分析 1994年～ 2 0 0 3年剖宫产率及其指征的变化 ,以及对围生儿病死率的影响。方法 :采用回顾性分析的方法 ,对 1994年～ 2 0 0 3年在我院分娩的 2 880 9例 ,其中剖宫产 115 6 4例的资料进行分析。结果 :1994年～ 2 0 0 1年剖宫产率呈逐年上升趋势 ,2 0 0 2年～ 2 0 0 3年稍有下降。难产一直位居剖宫产指征首位。 1994年～ 1998年瘢痕子宫位居第二 ,近 5a有下降趋势 ,而胎儿窘迫构成呈逐年上升趋势。社会因素逐年升高 ,至 2 0 0 1年已跃居第二位。臀位发生率呈逐年下降趋势。围生儿病死率 1994年～ 1998年为 15 .71‰ ,1999年～ 2 0 0 3年为 14 .5 8‰ ,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产儿病死率 ,但随剖宫产的进一步升高 ,围生儿病死率并未随之下降 ,加强孕产期保健及对产妇和家属的宣教工作 ,严格掌握剖宫产指征 ,将有助于降低剖宫产率。

Objective:To study the cesarean section rate and the changes of cesarean section indication in 1994～2003 as well as their influences on perinatal mortality rate.Methods:28809 cases of delivery,among which,11564 cesarean section cases occurred in our hospital from 1994 to 2001 were analyzed retrospectively.Results:The cesarean section rate in 1994～2001 had increased gradually,though there was a fall in 2002～2003.Dystocia ranks first in cesarean section indication,scar uterus the second in 1994～1998,with a trend of downward in the recent five years,whereas,there is upward trend for fetal distress.Social factors rises to the second place up to 2001.Breech presentation had decreased gradually.Perinatal mortality was 15.71‰ in 1994～1998,while the one in 1999～2003 was 14.58‰,making no obvious differences in between(P>0.05).Conclusion:The increase of cesarean section rate leads to the decrease of perinatal mortality rate to some extent.However as the cesarean section rate continue increasing,the perinatal mortality rate is not inclined to decline.Therefore,we should strengthen the implementation of the health care to the pregnant women in their pregnancy,through promoting education to them and their family,and have a grasp of the cesarean section indication,which will contribute a lot to decreasing the cesarean section rate.