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目的通过对影响剖宫产率相关因素的分析,探讨降低剖宫产率的有效干预措施,保障母婴健康。方法回顾分析禅城区中心医院2007～2011年23287例产妇的剖宫产率、剖宫产指征。结果总剖宫产率为40.76%。2011年剖宫产率(45.78%)较2007年(35.30%)明显上升,差异有统计学意义(P<0.05);其中,胎儿因素、母亲因素分别为46.66%、28.02%,较2007年(分别为40.41%、23.22%)明显升高且位居第一、第二位;而2011年宫内因素和社会因素分别为12.34%和1.81%,较2007年(分别为17.04%和9.32%)明显下降,差异有统计学意义(P<0.05)。剖宫产因素主要为瘢痕子宫(18.91%)、胎儿窘迫(17.69%)、脐带绕颈(16.78%)、头盆不称(8.64%)、胎膜早破(7.72%)、胎位异常(7.03%)、妊娠合并症(6.59%)、羊水过少(5.44%)、骨产道狭窄(2.23%)、巨大儿(1.92%)、高龄初产(1.69%)等。结论提高孕产期保健质量,积极治疗妊娠期合并症,提高助产技术水平,合理掌握手术指征,加强医患沟通,可有效降低剖宫产率。
Objective To analyze the factors that influence the rate of cesarean section, and to explore effective interventions to reduce the rate of cesarean section to protect the health of mothers and children. Methods The cesarean section rate and cesarean section indications of 23 287 maternal women in Chancheng Central Hospital from 2007 to 2011 were retrospectively analyzed. Results The total cesarean section rate was 40.76%. The rate of cesarean section in 2011 (45.78%) was significantly higher than that in 2007 (35.30%), the difference was statistically significant (P <0.05). Among them, the factors of fetus and mothers were 46.66% and 28.02% Respectively, 40.41% and 23.22% respectively), ranking the first and second place. In 2011, the intrauterine factors and social factors were 12.34% and 1.81% respectively, up from 17.04% and 9.32% respectively in 2007 Significantly decreased, the difference was statistically significant (P <0.05). Cesarean section was mainly caused by uterine scar (18.91%), fetal distress (17.69%), cord around the neck (16.78%), cephalopelvic disproportion (8.64%), premature rupture of membranes (7.72% , Pregnancy complications (6.59%), oligohydramnios (5.44%), stenosis (2.23%), macrosomia (1.92%) and advanced age (1.69%). Conclusions Improving the quality of maternal health care, actively treating complications during pregnancy, improving the technical level of midwifery, grasping surgical indications reasonably and strengthening communication between doctors and patients can effectively reduce the rate of cesarean section.