2015年~2019年36603例住院分娩病例临床分析  

Clinical analysis of 36 603 delivery cases in a hospital in 5 years: a retrospective study

作　　者：陈淑花[1] 马培玉[1] 任润发 CHEN Shuhua;MA Peiyu;REN Runfa(Anqiu Maternal and Child Health Hospital,Anqiu 262100,China)

机构地区：[1]安丘市妇幼保健院妇产科,山东安丘262100

出　　处：《潍坊医学院学报》2022年第6期427-430,共4页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫健委科研项目计划资助课题(项目编号:WFWSJK-2021-242)。

摘　　要：目的 调查安丘市妇幼保健院5年来产科住院患者经阴分娩率、剖宫产率及新生儿窒息率变化情况,探讨降低剖宫产率和新生儿窒息率的方法。方法 选取2015年1月~2019年12月产科住院分娩患者,分析其分娩方式、剖宫产原因、新生儿窒息情况。结果 2015年~2019年36 603例中经阴分娩19 420例,剖宫产17 183例,剖宫产率从46.97%升至48.60%(P<0.05)。侧切4620例,侧切率从32.61%降至18.36%(P<0.05)。剖宫产中瘢痕子宫从32.77%上升至42.84%(P<0.05)。以社会因素、巨大儿、胎儿窘迫为指征的剖宫产分别从20.88%,9.02%,7.95%降至19.08%,6.58%,6.29%.社会因素指征差异有统计学意义(P<0.05)。36 603例新生儿中发生窒息233例(0.637%),主要原因为胎儿、产妇和产科医疗因素。结论 瘢痕子宫妊娠的孕产妇增加是剖宫产率上升的主要原因,初产妇的剖宫产指征需合理掌握。Objective To investigate the distribution of vaginal delivery, cesarean section and neonatal asphyxia rate in the past five years, and explore the approaches to reduce the cesarean section and neonatal asphyxia rate.Methods The obstetric inpatients were collected from January 2015 to December 2019,and the methods of delivery, causes of cesarean section, status of neonatal asphyxia were analyzed.Results A total of 36 603 cases were collected, including 19 420 cases of vaginal delivery and 17 183 cases of cesarean section.The cesarean section rate is increasing from 46.97% to 48.60%(P<0.05).There were 4620 cases of lateral resection, and the rate of lateral resection decreased from 32.61% to 18.36%(P<0.05).The proportion of scarred uterus increased significantly, from 32.77% to 42.84%(P<0.05).The cesarean section indicated by social factors, macrosomia, and fetal distress has shown a downward trend, from 20.88%,9.02% and 7.95% to 19.08%,6.58% and 6.29%,respectively.The difference in the indications of social factors was statistically significant(P<0.05).Among 36 603 newborns, 233 cases(0.637%)of neonatal asphyxia occurred, The main causes of neonatal asphyxia were fetal, maternal and obstetric medical factors.Conclusion The increase of pregnant women with scar uterus pregnancy is the main reason for the increase of cesarean section rate.It is necessary to strengthen comprehensive prevention and intervention of social, maternal and obstetric medicine for better reducing the rate of cesarean section and neonatal asphyxia.

关 键 词：住院分娩 经阴分娩率 终止妊娠 剖宫产率 瘢痕子宫 新生儿窒息 

分 类 号：R714.3[医药卫生—妇产科学]