产科医师对社会因素剖宫产率的影响分析  

The Role of Obstetricians in the Decision-making of Cesarean Section for Social Factors

作　　者：孙晓娟 于慧 雷萍 李连芹 SUN Xiaojuan;YU Hui;LEI Ping;LI Lianqin(Department of Reproductive Medicine,Yantai Affiliated Hospital of Binzhou Medical University,Yantai Shandong 264100,China;Department of Obstetrics and Gynecology,Binzhou Medical University,Yantai Shandong 264003,China)

机构地区：[1]滨州医学院烟台附属医院生殖医学科,山东烟台264100 [2]滨州医学院妇产科教研室,山东烟台264003

出　　处：《中国继续医学教育》2021年第35期78-82,共5页China Continuing Medical Education

基　　金：国家卫生健康委生殖健康重点实验室开放课题(20037717)。

摘　　要：目的探讨产科医师对于孕妇因社会因素选择剖宫产的影响作用。方法回顾分析2017年1月—2019年12月在本院实施剖宫产的初产妇资料,并比较在门诊产前检查期间,不同接诊产科医师之间在剖宫产指征等方面的差异。结果本研究共纳入6084例孕妇,其在整个孕期接受同一产科医师产前检查10次以上,其中1965例实施了剖宫产手术,剖宫产率为32.3%。分析发现,不同接诊医生的患者剖宫产率、手术指征占比存在差异,个别医生以"社会因素"为手术指征的病例明显高于同期其他医师(P<0.05)。结论产科医生对于孕妇的分娩心理具有重要影响。在医疗实践中,产科医师应不断接受医学人文教育和专业知识培训,充分认识剖宫产对母婴的危害,而且整个产前检查过程中,应当加强对孕妇的宣教,使其充分认识自然分娩和剖宫产的利弊,为将来的分娩做好身体和精神方面的准备,配合医生选择最恰当的分娩方式,从而降低社会因素剖宫产率以及与此相关的并发症。Objective To analyze the difference of cesarean section indications between individual obstetricians and investigate the role of obstetricians in the decision-making of cesarean delivery for social factors. Methods Clinical data of cesarean delivery cases in the hospital between January of 2017 and December of 2019 were analyzed, and the cesarean section indications between individual obstetricians were compared. Results The present study included 6 084 pregnant women that received prenatal examination for more than 10 times from the same obstetrician. 1 965 cases underwent cesarean section, accounting for 32.3%. The cesarean section rate and the indication percentage for cesarean section were different among individual obstetric doctors.One or two obstetricians showed significantly more cases of cesarean section for social factors in their patients than other obstetric doctors(P<0.05). Conclusion Obstetricians might play an important role in the decision-making of caesarean section for social factors by affecting the delivery psychology of pregnant women. Obstetricians themselves should fully realize the complications of the cesarean section. Health education is needed to provide physical and mental support for pregnant women, which would be helpful in the decrease of social factorrelated cesarean section.

关 键 词：剖宫产 产科医师 社会因素 分娩 手术指征 孕妇 

分 类 号：R714[医药卫生—妇产科学]