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目的:探讨基层医院剖宫产指征与结局的关系。方法:回顾性分析1134例产妇剖宫产指征及结局。结果:我院2009年1月～2012年12月平均剖宫产率为27.3%,部宫产率呈逐年上升的趋势,2012年(31.3%)高于其它3年,但差异无统计学意义(P>0.05)。剖宫产指征前5位分别是胎儿宫内窘迫、羊水过少、胎膜早破、社会因素、子痫前期等为主。1134例剖宫产中,9例围产儿死亡,围产儿死亡率7.9‰。产妇无1例产妇死亡,产妇并发症中产后出血26例(2.3%),产褥感染及产褥病率23例(2.0%),腹部切口愈合不良8例(0.7%),晚期产后出血5例(0.4%)。其中7例(0.6%)腹部切口愈合不良或感染患者行2次手术。结论:剖宫产率呈逐年上升趋势,基层医院应合理掌握剖宫产指征,在保证母婴平安的前提下,尽量鼓励产妇选择阴道分娩方式。
Objective: To investigate the relationship between cesarean section indications and outcomes in primary hospitals. Methods: A retrospective analysis of 1134 maternal cesarean indications and outcome. Results: The average rate of cesarean section in our hospital from January 2009 to December 2012 was 27.3%. The rate of uterine decoction increased year by year and was higher than that of the other three years in 2012 (31.3%), but the difference was not statistically significant (P> 0.05). The first 5 cesarean indications were fetal distress, oligohydramnios, premature rupture of membranes, social factors, such as preeclampsia. Of the 1134 cesarean sections, nine were perinatal and the perinatal mortality was 7.9 per 1,000. No maternal deaths were found in 1 maternal postpartum, 26 (2.3%) postpartum hemorrhages in maternal complications, 23 cases (0.2%) in puerperal infection and puerperal morbidity, 8 cases (0.7%) in poor abdominal incision healing, 5 postpartum hemorrhage Example (0.4%). Among them, 7 cases (0.6%) had poor incision healing or infected patients underwent 2 surgeries. Conclusion: The rate of cesarean section shows an upward trend year by year. The primary hospital should have a reasonable grasp of cesarean section indications. Under the premise of ensuring the safety of mother and baby, the mothers should be encouraged to choose vaginal delivery as far as possible.