基层医院剖宫产率与剖宫产指征临床研究.docVIP

基层医院剖宫产率与剖宫产指征临床研究 　　【摘 要】目的：探讨基层医院剖宫产率与剖宫产指征的临床研究。方法：回顾性分析我院在2007年1月到2013年1月收治的4000例足月分娩者的临床资料，探讨基层医院剖宫产率与剖宫产指征变化。结果：前3年的剖宫产率为24.0%，后3年的剖宫产率为45.6%，基层医院的剖宫产率呈逐年上升的趋势；从剖宫产的影响因素分析，胎儿窘迫率降低到 16.9%，头位难产率上升为36.4%；社会因素从2.0%上升到8.7%，头位难产逐渐代替了胎儿窘迫症，剖宫产指征的顺位也发生了显著变化，单因素的指征呈逐年增加的形式，多因素指征逐年下降。结论：剖宫产率的增加能够在一定程度上降低新生儿死亡率，对剖宫产指征进行严格掌握，尽量减少剖宫产率。 　　【关键词】基层医院；剖宫产率；剖宫产指征；临床研究 　　The Clinical Research on Cesarean Section Rate and Caesarean Section Indication of Primary Hospitals 　　Chen Chunli 　　Department of Gynaecology and Obstetrics， the Fourth People’s Hospital， Nanhai District， Foshan 528211[Abstract]Objective： Discuss on the clinical research on cesarean section rate and caesarean section indication of primary hospitals. Methods： Review and analyze the clinical materials of 4000 cases of puerperae with term delivery during January 2007 to January 2013 of the hospital， and discuss on the changes of the cesarean section rate and caesarean section indications of primary hospitals. Results： The cesarean section rate during the first three years of the designated period is 24.0%， while the one during the last three years is 45.6%， in which the cesarean section rate of primary hospitals shows a annual climbing trend； Analyze from the influence factors of the cesarean section， the incidence of fetal distress decreased to 16.9%， while the incidence of cephalic presentation dystocia increased to 36.4%， and social influence counted from 2.0% rose to 8.7%.Cephalic Presentation Dystocia has gradually replaced the Fetal Distress to become the determining factor of applying cesarean section. The cesarean section indications priority has also gone through prominent changes， in which the rate of indication of single factor develops annually， while the rate of indication of multi factors declines annually. Conclusion： The increase of cesarean section rate can bring down the neonatal mortality rate in certain degree. The indications of cesarean section should be supervised and controlled strict