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目的:调查二级甲等医院2005年和2010年剖宫产率及剖宫产原因,探讨剖宫产率上升的影响因素。方法:调取2005年和2010年4 235例次产科住院分娩患者资料,采用回顾性调查研究方法,分年度统计剖宫产率,对剖宫产原因进行对比分析,讨论剖宫产率升高的影响因素。结果:2010年二级甲等医院剖宫产率为51.20%,比2005年的46.08%上升了5.12%;与2005年比较,2010年剖宫产原因构成比前5位是:瘢痕子宫、无医学指征的剖宫产、胎位异常、巨大胎儿和胎膜早破,构成比上升明显的有:瘢痕子宫、巨大胎儿、多胎妊娠、脐带异常、产程异常、胎儿宫内窘迫和早产;导致剖宫产率上升的剖宫产原因依次是:妊娠合并其他疾病、胎盘异常、妊娠期高血压疾病、早产、胎位异常、巨大胎儿、过期妊娠、瘢痕子宫、无医学指征的剖宫产、胎儿宫内窘迫和头盆不称。结论:二级甲等医院剖宫产率逐年上升,社会因素是剖宫产率上升的主要原因,占41.19%;瘢痕子宫剖宫产构成比明显上升,2010年达16.45%;产科并发症或合并症选择剖宫产指征过于放宽。
Objective: To investigate the causes of caesarean section rate and cesarean section in Class A and Class-A hospitals in 2005 and 2010 and to explore the influencing factors of cesarean section rate increase. Methods: The data of 4 235 cases of obstetrics and gynecology hospital delivery in 2005 and 2010 were retrieved. By retrospective investigation and study method, the cesarean section rate was calculated every year. The causes of cesarean section were compared and analyzed. The cesarean section rate was increased The impact of factors. Results: In 2010, the rate of cesarean section in Grade A hospitals was 51.20%, up 5.12% from 46.08% in 2005. Compared with 2005, the cause of cesarean section in 2010 was 5% Cesarean section, abnormal fetal position, macrosomia, and premature rupture of membranes in medical indications were significantly higher than those in the other groups: hypertrophic scar, huge fetus, multiple pregnancy, umbilical cord abnormality, labor abnormality, fetal distress and premature labor; Cesarean section rate of increase of cesarean section causes were: pregnancy with other diseases, placental abnormalities, hypertensive disorders of pregnancy, premature birth, abnormal fetal position, huge fetus, overdue pregnancy, scar uterus, cesarean section without medical indications, fetal Uterine distress and cephalopelvic disproportion. Conclusion: The rate of cesarean section in Grade A hospitals is increasing year by year. The social factor is the main reason for the increase of cesarean section rate, accounting for 41.19%. The constituent ratio of cesarean section in scarring uterus is obviously increased, reaching 16.45% in 2010. Complications of choice cesarean indications too relaxed.