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目的分析昆明市助产机构剖宫产现况,探讨相关的解决措施。方法采用SPSS 18.0软件对昆明市2008-2014年妇幼卫生统计年报表及全市助产机构分娩登记本信息进行统计分析。结果 2008-2014年间,昆明市助产机构年度总分娩量呈上升趋势;2008年至2011年间,全市剖宫产率一直在42%-44%期间,2012年开始明显下降,为42.77%,2014年下降至32.77%;2012年至2014年剖宫产指征顺位前5位均为瘢痕子宫、社会因素、臀(横)位、头盆不称、胎儿窘迫,其中,社会因素构成比从2012年的首位(21.7%)降至2014年的第5位(6.02%),而瘢痕子宫构成比从21.2%上升至37%;全市初次剖宫产率从2012年的34.09%下降至23.60%。结论控制社会因素剖宫产和初次剖宫产率是降低剖宫产率的关键点。通过加强行政管理力度、监督指标落实、制定降低剖宫产率支持政策、强化培训,推广适宜技术、加强健康教育和提高孕产期保健服务质量等一系列措施可有效控制剖宫产率。
Objective To analyze the status of cesarean section in the midwifery in Kunming and to explore the related measures. Methods SPSS 18.0 software was used to analyze the statistics of MCH statistics in Kunming from 2008 to 2014 and the information of birth registration of the city’s midwifery. Results During 2008-2014, the total annual deliveries of Kunming midwifery was on an upward trend. During the period from 2008 to 2011, the cesarean section rate in the city was between 42% and 44%. The rate of cesarean section decreased significantly from 2012 to 42.77% 2014 Year to 32.77%. The top 5 indications of cesarean section from 2012 to 2014 were all scarring uterus, social factors, buttocks (lateral) position, cephalopelvic disproportion, and fetal distress. Among them, the ratio of social factors The first place (21.7%) in 2012 dropped to fifth place (6.02%) in 2014, while the ratio of scarring uterus increased from 21.2% to 37%; the city’s first cesarean section rate dropped from 34.09% in 2012 to 23.60% . Conclusion Control of social factors cesarean section and initial cesarean section rate is the key point to reduce cesarean section rate. A series of measures such as strengthening administrative management, supervising the implementation of indicators, formulating support policies for reducing cesarean section rate, strengthening training, promoting appropriate technologies, strengthening health education and improving the quality of maternal health care services can effectively control the rate of cesarean section.