剖宫产适应证回顾性分析  

Retrospective Analysis of Indications for Cesarean Section

作　　者：邓昆芳 周世梅 

机构地区：[1]宜宾县计划生育服务站,四川宜宾644600 [2]宜宾县妇幼保健院,四川宜宾644600

出　　处：《中国现代医生》2010年第8期94-96,共3页China Modern Doctor

摘　　要：目的回顾性分析剖宫产的适应证、并发症。方法回顾性分析我计划生育服务站2007年10月～2009年10月730例剖宫产的手术原因、手术并发症、新生儿Apgar评分、围生儿死亡率。结果剖宫产率为同期住站分娩(1084例)的67.3%,其中社会因素423例(57.9%),医学病理因素307例(42.1%)。在医学病理因素中胎儿窘迫93例(30.3%)、瘢痕子宫48例(15.6%)、胎膜早破42例(13.6%)、脐带绕颈35例(11.4%)、高龄初产30例(9.8%)。并发症包括切口液化延迟愈合15例(2.05%)、产后出血10例(1.4%)、切口感染1例(0.1%)、下肢静脉血栓1例(0.1%)、轻度新生儿窒息99例(13.5%)、重度新生儿窒息4例(0.5%)、新生儿死亡4例(0.5%)。结论社会因素、胎儿因素、产妇因素、医疗纠纷、医疗保险等均可导致剖宫产率增加,其中以社会因素为主要因素。剖宫产对母体及新生儿均有不良影响,且不能降低围产儿的病死率,因此降低剖宫产率关键是减少社会因素,严格掌握手术适应证,加强围生期保健,广泛宣传剖宫产的适应证和并发症,广泛开展导乐分娩或无痛分娩。Objective Retrospective analysis of cesarean section indications,complications. Methods Retrospective analysis of my family planning service station in October 2007-2009 years,730 cases of cesarean section in Octber because of surgery,surgical complications, neonatal Apgar score, perinatal mortality in children. Results Cesarean birth rate for the same period in living Station （1084 cases） 67.3%, in which social factors, 423 cases（57.9%）, medical pathology factors,307 cases42.1%）,in the medical-pathological factors in 93 cases of fetal distress（30.3%） ,48 cases of uterine scar（ 15.6% ）, premature rupture of membranes 42（ 13.6% ）, umbilical cord entanglement in 35 cases （11.4%）, elderly primiparous 30 cases（9.8% ）. Complications included delayed healing of incision liquefaction in 15 eases（2.05%）, postpartum hemorrhage in 10 cases（1.4%）, wound infection in 1 case（0.1%）, deep vein thrombosis in 1 case（0.1%）, mild 99 cases of neonatal asphyxia（ 13.5% ）, severe neonatal asphyxia in 4 eases（0.5% ）, neonatal deaths, 4 eases（0.5% ）. Conclusion Social factors,fetal factors, maternal factors, medical disputes, and medical insurance may also lead to cesarean section rate increased, of which social factors as the main factors that have a cesarean section on maternal and neonatal adverse effects,but not reduce perinatal the case fatality rate, thus reducing the cesarean section rate is to reduce the key social factors, surgical indications strictly controlled to enhance perinatal care, widely publicized indications and complications of cesarean section, and extensively carried Doula childbirth or painless childbirth.

关 键 词：剖宫产 适应证 并发症 

分 类 号：R731.141[医药卫生—肿瘤]