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目的:探讨深圳市龙岗区各级医院剖宫产指征的掌握情况。方法:对2010年度深圳市龙岗区各级医院收治的13 764例剖宫产患者的临床资料进行回顾性分析。结果:本区总的剖宫产率为37.27%。疤痕子宫(19.51%)、胎儿窘迫(15.77%)、社会因素(15.71%)是本区剖宫产指征的前三位。二级医院中疤痕子宫(20.42%)居剖宫产指征的第一位,民营医院中社会因素(23.16%)居剖宫产指征的第一位。二级医院中因子痫前期、妊娠期糖尿病、妊娠合并内外科疾病、妊娠期肝内胆汁淤积症、胎盘脐带异常等高危因素而行剖宫产手术的比例以明显高于一级公立医院和民营医院:一级医院和民营医院中以相对头盆不称、产程异常等明确的产科因素为剖宫产指征的比例明显高于二级医院。结论:应加强孕期宣教,增强医患沟通,避免过度诊断,加强医疗市场监管,减少无医学指征剖宫产。
Objective: To investigate the indications of cesarean section at all levels of hospitals in Longgang District, Shenzhen. Methods: The clinical data of 13 764 cesarean patients admitted to hospitals at all levels in Longgang District in 2010 were analyzed retrospectively. Results: The total cesarean section rate in this area was 37.27%. Scarring uterus (19.51%), fetal distress (15.77%) and social factors (15.71%) are the top three indicators of cesarean section in this area. In the secondary hospitals, the number of scar uterus (20.42%) was the first indication of cesarean section indications. The social factors in private hospitals (23.16%) were the first indications of cesarean section. In secondary hospitals, the proportion of cesarean section patients who underwent high risk factors such as preeclampsia, gestational diabetes mellitus, pregnancy and surgical diseases, intrahepatic cholestasis of pregnancy, and abnormalities of placenta umbilical cord were significantly higher than those of first-class public hospitals and private-owned hospitals Hospitals: First-tier hospitals and private hospitals in the relative head basin is not known, abnormal labor and other specific obstetric factors for cesarean indications was significantly higher than the two hospitals. Conclusion: It is necessary to strengthen prenatal education during pregnancy, enhance communication between doctors and patients, avoid overdiagnosis, strengthen medical market supervision and reduce cesarean section without medical indications.