2019—2022年安徽省产科哨点医院剖宫产率及指征变化分析  

Analysis on change of cesarean section rate and indication in obstetrics sentinel hospitals in Anhui Province from 2019 to 2022

作　　者：纪瑞云 陈磊 蒋晓敏 方向东 刘辉 JI Rui Yun;CHEN Lei;JIANG Xiao Min;FANG Xiang Dong;LIU Hui(Anhui Province Maternity&Child Health Hospital,Hefei 230001,Anhui Province,China)

机构地区：[1]安徽省妇幼保健院,安徽合肥230001

出　　处：《中国妇幼卫生杂志》2023年第4期3-7,共5页Chinese Journal of Women and Children Health

摘　　要：目的分析2019—2022年安徽省产科哨点医院剖宫产率、非医学指征剖宫产率、初产妇剖宫产率及剖宫产指征变化情况,并比较不同类型医院间的差异。方法利用安徽省产科哨点医院监测网络,收集2019—2022年23家哨点医院产妇相关质控指标,采用χ^(2)检验对不同类型医院的剖宫产率、非医学指征剖宫产率、初产妇剖宫产率、剖宫产指征等数据进行统计学分析。结果2019—2022年安徽省23家哨点医院的剖宫产率均在2020年增长至峰值后出现下降,平均剖宫产率为45.54%;非医学指征剖宫产率呈缓慢上升,平均非医学指征剖宫产率为3.54%;2019年初产妇剖宫产率为33.71%,2020年快速增长至36.81%,2021年后逐渐下降。综合医院剖宫产率、非医学指征剖宫产率、初产妇剖宫产率均高于专科医院,差异均有统计学意义(均P<0.05)。综合医院的多胎妊娠、凶险性前置胎盘、妊娠合并症与并发症、重度胎盘早剥等指征的比例也均高于专科医院,差异均有统计学意义(均P<0.05)。结论安徽省哨点医院剖宫产率有待进一步控制,非医学指征剖宫产率和初产妇剖宫产率是剖宫产率增长的主要原因。综合医院的剖宫产率、非医学指征剖宫产率、初产妇剖宫产率均高于专科医院,应予以特别关注和重视;综合医院和专科医院的剖宫产指征构成有一定区别。Objective To analyze the changes of cesarean section rate,the cesarean section rate without medical indications,the primipara cesarean section rate and cesarean section indications in obsterics sentinel hospitals in Anhui Province from 2019 to 2022,and to compare the differences among different hospitals.Methods The quality control indicators in 23 sentinel hospitals from 2019 to 2022 were collected through the monitoring network of obstetric sentinel hospitals in Anhui Province.Chi-square test was used to analyze cesarean section rate,cesarean section rate without medical indications,cesarean section rate of primipara,and cesarean section indications in different types of hospitals.Results From 2019 to 2022,the cesarean section rate of 23 sentinel hospitals in Anhui Province was downward after increasing to the peak in 2020,with an average cesarean section rate of 45.54%.The cesarean section rate without medical indications showed a slow upward,with an average rate of 3.54%.Primipara cesarean section rate was 33.71%in 2019,increased rapidly to 36.81%in 2020,and then showed a gradual downward since 2021.The cesarean section rate,cesarean section rate without medical indications and primipara cesarean section rate in general hospitals were significantly higher than those in specialized hospitals(all P<0.05).The proportion of indications such as multiple pregnancy,pernicious placenta previa,pregnancy complications,and severe placental abruption in general hospitals were also significantly higher than those in specialized hospitals(all P<0.05).Conclusion The cesarean section rate in sentinel hospitals in Anhui Province needs to be further controlled.The rate of cesarean section without medical indications and the primipara cesarean section rate are the main reasons for the increase of cesarean section rate.The cesarean section rate,the rate of cesarean section without medical indications and the primipara cesarean section rate are significantly higher in general hospitals than those in specialized hospitals,which ne

关 键 词：剖宫产率 初产妇剖宫产率 剖宫产指征 瘢痕子宫 

分 类 号：R719.8[医药卫生—妇产科学]