高剖宫产率的原因分析及干预措施探讨  

Cause analysis and intervention measures of high cesarean section rate

作　　者：丛建萍[1] 杨静[1] CONG Jian-ping;YANG Jing(Shenyang Maternity and Infant Hospital,Shenyang 110011,China)

机构地区：[1]沈阳市妇婴医院,110011

出　　处：《中国实用医药》2021年第15期47-50,共4页China Practical Medicine

基　　金：2016年度辽宁省卫生计生委软科学研究项目(项目编号:LNWSSS-13)。

摘　　要：目的通过统计本院剖宫产率,分析其原因,并探讨降低剖宫产率的干预措施。方法回顾性分析2015年分娩产妇10294例、2016年分娩产妇16314例的临床资料。记录比较2015年及2016年剖宫产情况及其主要指征,采用Robson分类系统对2015年及2016年剖宫产率进行分析。结果2015年分娩产妇年龄(29.90±3.80)岁,剖宫产5022例,剖宫产率48.79%;2016年分娩产妇年龄(30.10±4.10)岁,剖宫产7307例,剖宫产率44.79%。2015年分娩产妇剖宫产率高于2016年,差异具有统计学意义(χ^(2)=40.529,P<0.05)。2015年分娩产妇剖宫产各项指征占比从高到低依次为社会因素971例(19.33%),瘢痕子宫953例(18.98%)、巨大儿584例(11.63%)、胎位异常487例(9.70%)、中转剖宫产442例(8.80%),2016年分娩产妇剖宫产各项指征占比从高到低依次为瘢痕子宫1507例(20.62%)、社会因素1303例(17.83%)、巨大儿725例(9.92%)、胎位异常694例(9.50%)、中转剖宫产653例(8.94%),2016年分娩产妇中瘢痕子宫占比高于2015年,社会因素、巨大儿占比均低于2015年,差异均具有统计学意义(χ^(2)=5.058、4.468、9.137,P<0.05)。根据Robson分类系统标准对2015年及2016年产妇进行分组,均以2组产妇的规模最大;其次为1组;其次是5组,且剖宫产权重上升最明显。结论本院剖宫产以瘢痕子宫及社会因素为主要原因,通过全程管理、减少社会因素剖宫产、提高阴道分娩助产技术、开展分娩镇痛方式等可降低剖宫产率。Objective To analyze the causes of cesarean section rate,and discuss the intervention measures to lower the cesarean section rate.Methods The clinical data of 10294 women who gave birth in 2015 and 16314 women who gave birth in 2016 was retrospectively analyzed.The situation of cesarean section in 2015 and 2016 and its main indications were recorded and compared,and the Robson classification system was used to analyze the cesarean section rates in 2015 and 2016.Results In 2015,the age of delivery women was(29.9±3.80)years old,cesarean section in 5022 cases,and the cesarean section rate was 48.79%;in 2016,the age of delivery women was(30.10±4.10)years old,cesarean section in 7307 cases,and the cesarean section rate was 44.79%.The cesarean section rate in 2015 was higher than that in 2016,and the difference was statistically significant(χ^(2)=40.529,P<0.05).In 2015,the proportion of cesarean section indications from high to low were 971 cases(19.33%)of social factors,953 cases(18.98%)of scarred uterus,584 cases(11.63%)of fetal macrosomia,and 487 cases(9.70%)of abnormal fetal position,442 cases(8.80%)of cesarean section conversion;in 2016,the proportion of cesarean section indications from high to low were 1507 cases(20.62%)of scarred uterus,1303 cases(17.83%)of social factors,725 cases(9.92%)of fetal macrosomia,694 cases(9.50%)of abnormal fetal position,and 653 cases(8.94%)of cesarean section conversion.The proportion of scarred uterus in 2016 was higher than in 2015,and the proportion of social factors and fetal macrosomia were lower than in 2015,and the difference was statistically significant(χ^(2)=5.058,4.468,9.137;P<0.05).According to the standard of Robson classification system,the women in 2015 and 2016 were grouped.The scale of Group 2 was the largest,followed by Group 1 and Group 5,and the weight value of Group 5 rise most obviously.Conclusion The main causes of cesarean section in this hospital are scarred uterus and social factors,and full management,reduction of social factors for cesarean section,i

关 键 词：剖宫产率 原因分析 干预措施 Robson分类系统 

分 类 号：R719.8[医药卫生—妇产科学]