某院2011—2017年剖宫产率与剖宫产指征变化的回顾性分析-现代医学

某院2011—2017年剖宫产率与剖宫产指征变化的回顾性分析

单位：扬州大学临床医学院/苏北人民医院妇产科, 江苏扬州 225001

分类号：R719.8

出版年·卷·期（页码）：2018·46·第十一期（1256-1261）

摘要：

目的：分析近7年剖宫产率与剖宫产指征的变化，进一步降低剖宫产率。方法：回顾性分析扬州市苏北人民医院2011年1月1日至2017年12月31日住院行剖宫产分娩的11 396例孕妇的临床资料。结果：（1）7年间，平均剖宫产率为53.75%，由2011年的57.72%下降为2017年的44.10%，差异有统计学意义（P<0.05）。（2）剖宫产手术指征构成比变化明显，社会因素呈明显下降趋势，由第1位逐年降至第12位。瘢痕子宫由第2位升为第1位。双胎珍贵儿、危重并发症、胎儿窘迫呈明显上升趋势。（3）产妇产后出血率及新生儿窒息率呈明显升高趋势（P<0.01），而新生儿死亡率无明显升高。结论：2011—2017年本院总体剖宫产率呈明显下降趋势，而新生儿死亡率并未随之升高，剖宫产指征构成发生了明显的改变，无指征剖宫产明显下降，瘢痕子宫成为剖宫产首要指征。

Objective:To analyze the changes of cesarean delivery rates and cesarean section indications in recent seven years in Northern Jiangsu People's Hospital, so as to further explore the measures that can reduce the cesarean section rate. Methods:Clinical data of women who gave birth inNorthern Jiangsu People's Hospital from 2011 to 2017 were retrospectively analyzed. The changes of cesarean delivery rates and cesarean section indications were examined. Results:(1) The rate of cesarean section was significantly decreased from 57.72% in 2011 to 44.10% in 2017 (P<0.01). (2) In terms of the indications of cesarean section, the rank of women who underwent cesarean section due to social factors tended to decrease from NO.1 to NO.12, and scarred uterus shifted from NO.2 to NO.1. The number of infertile women who were assisted with reproductive technology,and women who had twin pregnancy, severe complications and fetal distress showed a obvious rising trend. (3) The rate of postpartum hemorrhage and the rate of neonatal asphyxia in the obstetric department of our hospital showed a significant upward trend (P<0.01), but the neonatal mortality rate did not increase significantly. Conclusion:The cesarean section rate of our hospital tends to significantly decrease from 2011 to 2017,without increasingneonatal mortality. The cesarean section indications in delivery change from the social factors in the past to the scarred uterus at present.

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