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目的总结3个不同年代我院剖宫产率及剖宫产指征的变迁,探讨降低剖宫产率的措施。方法选择1997年8月至2000年8月、2004年8月至2007年8月及2011年8月至2014年8月在北京四季青医院分娩者,分为A、B、C组,分析其剖宫产率变化,将手术指征分为母亲因素、胎儿因素、头盆因素、社会因素、瘢痕子宫和其他因素,分别观察其所占比例的变化。结果随着时代的发展、医疗技术水平的提高、国家政策的变化,剖宫产率先升后降,由第一时代的17.80%上升到第二时代的43.71%,再降至第三时代的33.83%。在剖宫产指征上社会因素为指征的剖宫产率仍占13.79%,其变化与总剖宫产率相似,为先升后降,分别为7.30%、20.67%、13.79%,母亲因素、胎儿因素、头盆因素为指征的剖宫产率均呈现下降的趋势。瘢痕子宫及其他因素为指征的剖宫产率明显升高,达到28.18%、14.95%。结论近年社会因素的剖宫产得到有效的控制,在降低剖宫产率上的空间已经有限了,应降低瘢痕子宫为指征的剖宫产,以达到降低剖宫产率,减少对产妇的创伤和可能的并发症。
Objective To summarize the changes of cesarean section rate and indication of cesarean section in our hospital in three different ages and to explore the measures to reduce the rate of cesarean section. Methods From August 1997 to August 2000, August 2004 to August 2007 and August 2011 to August 2014 were delivered at Beijing Sijiqing Hospital, and were divided into groups A, B and C, Cesarean section rate changes, the surgical indications were divided into maternal factors, fetal factors, cephalic factors, social factors, scarring of uterus and other factors were observed changes in the proportion of their share. Results With the development of the times, the improvement of medical technology and the change of national policies, the rate of cesarean section first and then decreased from 17.80% in the first era to 43.71% in the second era and then to 33.83 in the third era %. Cesarean section indications for cesarean indications still accounted for 13.79% of cesarean section rate, the change is similar to the total cesarean section rate, first increased and then decreased, respectively, 7.30%, 20.67%, 13.79%, the mother Factors, fetal factors, cesarean section indications of cesarean section rate showed a downward trend. Cervical cesarean scar and other factors as indications of cesarean section rate was significantly increased, reaching 28.18%, 14.95%. Conclusion Social factors in recent years, cesarean section have been effectively controlled in reducing cesarean section rate on the space has been limited, should reduce the scarring of the uterus as an indication of cesarean section in order to reduce the rate of cesarean section and reduce maternal Trauma and possible complications.