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目的:分析长春地区不同等级医院的剖宫产率、剖宫产指征及其相关性,探讨有效降低剖宫产率的措施。方法:回顾性分析2011年吉林大学第二医院(A组)、农安县人民医院(B组)及榆树市妇幼保健院(C组)住院分娩的7 598例临床资料。结果:A组剖宫产率为75.75%,B组为81.56%,C组为75.14%,3组差异无统计学意义(P>0.05)。首位剖宫产指征均为社会因素,C组明显高于A组,差异有统计学意义(P<0.05)。产科并发症及合并症是A组的第二位剖宫产指征,与B、C组相比差异有统计学意义(P<0.01)。头盆不称在B组剖宫产指征中居第二位,与A、C组相比差异有统计学意义(P<0.01)。其他剖宫产指征与医院等级无相关性。结论:长春地区的剖宫产率明显高于国家平均水平,与医院等级无相关性,社会因素是影响剖宫产率的关键。
Objective: To analyze the cesarean section rate, cesarean section indications and their correlations in different levels of hospitals in Changchun area and to explore the effective measures to reduce the rate of cesarean section. Methods: A retrospective analysis of 7 598 clinical data of hospital delivery in 2011 was conducted at the Second Hospital of Jilin University (Group A), Nong’an People’s Hospital (Group B) and Yushu MCH (Group C). Results: The rate of cesarean section in group A was 75.75%, in group B 81.56% and in group C 75.14%. There was no significant difference between the three groups (P> 0.05). The first cesarean section indications were social factors, C group was significantly higher than the A group, the difference was statistically significant (P <0.05). Obstetric complications and comorbidities were the second cesarean section indications in group A, which were significantly different from those in groups B and C (P <0.01). The cephalopelvic disproportion was the second place in group B with cesarean indications, and the difference was statistically significant compared with group A and C (P <0.01). Other cesarean indications had no correlation with hospital grade. Conclusion: The rate of cesarean section in Changchun area was significantly higher than the national average level and had no correlation with hospital grade. The social factors were the key factors affecting the rate of cesarean section.