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目的回顾性调查某医院近两年剖宫产率及手术指征构成的变化。方法从某院病案首页信息管理系统中检索2015年-2016年住院期间进行剖宫产和顺产的所有产妇的病案首页数据进行分析核查。结果 2015年与2016年剖宫产率分别为46.89%和51.01%,2016年剖宫产率高于2015年;剖宫产主要手术指征顺位排序前四位为“妊娠合并子宫瘢痕”、“脐带问题”、“胎儿先露异常”和“母体骨盆或盆腔器官异常”;其中2016年“妊娠合并子宫瘢痕”所占的比例高于2015年,“脐带问题”与“母体骨盆或盆腔器官异常”这两种手术指征所占的比例低于2015年,而不同年份的“胎儿先露异常”的指征所占的比例没有显著差异;在以“妊娠合并子宫瘢痕”为主要手术指征的剖宫产组和具有“妊娠合并子宫瘢痕”的顺产组的产妇中,剖宫产组的年龄高于顺产组;相较于省内产妇,省外产妇更倾向于顺产;多胎产妇剖宫产的比例高于单胎产妇,但两组产妇的妊娠伴随症、妊娠并发症以及怀有巨大儿的比例均没有差异。结论 2016年剖宫产率升高与“妊娠合并子宫瘢痕”手术指征有关,为合理选择分娩方式,降低剖宫产率,医师应对具有剖宫产史的产妇进行严格的监测,避免剖宫产手术指征的滥用。
Objective To retrospectively investigate the change of caesarean section rate and operation indications in a hospital in recent two years. Methods The data of the first case of cesarean section and all pregnant women during hospitalization from 2015 to 2016 were retrieved from the information system of medical records of a hospital for analysis and verification. Results The rates of cesarean section in 2015 and 2016 were 46.89% and 51.01%, respectively. The rate of cesarean section in 2016 was higher than that in 2015. The top four indications of major surgical indications of cesarean section were “pregnant women with uterine scar, ”,“ Umbilical cord problem ”,“ fetal anomaly ”and“ maternal pelvic or pelvic organ abnormalities ”; in 2016,“ the proportion of pregnancy complicated with uterine scar ”was higher than in 2015, The ratio of “umbilical cord problem” to “maternal pelvis or pelvic organ abnormality” accounted for less than 2015 and that of “fetal anomaly” in different years There was no significant difference; in the cesarean section with “pregnant women with uterine scar ” as the main surgical indications of cesarean section group and with “pregnant women with uterine scar” Group; compared with the provincial maternal, provincial maternity more prone to natural delivery; multiple birth cesarean section than singleton maternal ratio, but the two groups of maternal pregnancy complications, pregnancy complications, as well as pregnant with huge children were no difference. Conclusion The increase of cesarean section rate in 2016 is related to the indications of “pregnancy-associated uterine scar”. In order to choose the mode of delivery reasonably and reduce the rate of cesarean section, physicians should strictly monitor the maternal women with history of cesarean section and avoid Cesarean section indication of abuse.