我院2012~2019年剖宫产率及剖宫产手术指征变化分析  

Analysis on the changes of cesarean section rate and the indication of cesarean section from 2012 to 2019 in our hospital

作　　者：陈小芸 CHEN Xiao-yun(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Fujian Medical University,Fujian Province,Fuzhou350005,China)

机构地区：[1]福建医科大学附属第一医院妇产科,福建福州350005

出　　处：《中国当代医药》2020年第31期192-196,共5页China Modern Medicine

摘　　要：目的研究2012~2019年我院剖宫产率及剖宫产手术指征的变化。方法选取福建医科大学附属第一医院2012年1月1日~2019年12月31日住院分娩的20289例孕产妇,其中剖宫产11010例。比较各年份的剖宫产率情况,分析剖宫产手术指征变化的趋势,提出降低剖宫产率的措施。结果2012~2019年我院剖宫产率逐年下降,2019年的剖宫产率为50.500%,低于2012年的61.159%,差异有统计学意义(P<0.05)。社会因素和瘢痕子宫位居所有剖宫产手术指征的第1、2位,瘢痕子宫占比逐年上升,其前两年顺位第2,到后6年均跃居第1位;而社会因素占比则反之逐年下降,2012~2013年顺位第1,2014~2018年降至第2,2019年下降至第4,其年份间比较差异有统计学意义(P<0.05)。妊娠合并症及并发症占比逐年上升,而产程时限异常占比逐年下降,各年份间比较差异均有统计学意义(P<0.05)。结论我院近8年剖宫产率逐年下降,但仍较高。其主要原因是瘢痕子宫、妊娠合并症及并发症孕妇增多。应严格把握首次剖宫产指征,尽量缩减无医学指征的剖宫产,规范应用新产程,给予充分试产,提高阴道分娩率,进而达到降低剖宫产率的终极目标。Objective To study the changes of cesarean section rate and indication of cesarean section in our hospital from 2012 to 2019.Methods A total of 20289 pregnant women who labor in the First Affiliated Hospital of Fujian Medical University from January 1,2012 to December 31,2019 were selected,among which 11010 were delivered by cesarean section.The cesarean section rates in each year were compared,the trend of changes in indications of cesarean section operation were analyzed,and the measures of reducing the cesarean section rate were proposed.Results The rate of cesarean section in our hospital decreased year by year from 2012 to 2019.The rate of cesarean section in 2019 was 50.500%,which was lower than that of 61.159%in 2012,and the difference was statistically significant(P<0.05).Social factors and scar uterus ranked first and second among all indications of cesarean section operation.The proportion of scar uterus increased year by year,and it ranked second in the first two years and jumped to the first place in the next six years.On the contrary,the proportion of social factors has decreased year by year,it ranked the first in 2012-2013,the second in 2014-2018,and fell to the fourth in 2019,there were differences in comparison between the years(P<0.05).The pregnancy comorbidities and complications increased year by year,while the abnormal labor decreased year by year,the differences between the years were statistically significant(P<0.05).Conclusion The cesarean section rate of our hospital has decreased year by year in the past 8 years,but it is still relatively high.The main reason is the increased number of pregnant women with scarred uterus,pregnancy comorbidities and complications.The indications of the first cesarean section should be strictly controlled,the cesarean section without medical indications should be reduced as far as possible,the new stage of labor should be standardized,the full trial production should be given,and the vaginal delivery rate should be increased,so as to achieve the ultimate go

关 键 词：剖宫产率 剖宫产指征 瘢痕子宫 社会因素 

分 类 号：R719.8[医药卫生—妇产科学]