近7年剖宫产率及剖宫产指征的变化
发布时间：2018-07-25 14:53
【摘要】：目的：剖宫产术是处理高危妊娠、异常分娩、挽救孕产妇和围生儿生命的有效手段。随着各种剖宫产术式的成熟与完善,其他相关医学领域的发展,使剖宫产的安全性大大提高,在临床上得到广泛应用；研究证实剖宫产率的升高在一定范围内可以降低孕产妇及围产儿的死亡率；社会经济迅速发展,计划生育的大力推广,胎儿尤为珍贵,且孕妇对阴道分娩缺乏信心,要求行剖宫产；医患矛盾及医疗纠纷的逐渐增加,没有健全的医疗法律法规,制约了产科医生选择临床治疗策略等,这些因素促使我国的剖宫产率成为世界第一,并引起国内外产科领域的广泛关注。因此探讨高剖宫产率的原因及控制剖宫产率成为目前研究的焦点。鉴于此,本研究通过分析7年间剖宫产率及剖宫产指征的变化,为控制剖宫产率提出合理的措施,指导孕妇选择合理的分娩方式,提高产科质量。方法：回顾性分析2006年1月至2012年12月山西医科大学第一医院产科6402例行剖宫产手术分娩产妇的病例资料,描述7年间剖宫产率及剖宫产指征的变化情况。 结果： (1)剖宫产率总体呈下降趋势,差异有统计学意义(χ2=205.717,P=0.0010.05)。 (2)7年的剖宫产指征变化中,妊娠合并症及并发症(χ2=43.906,P=0.0010.05)、瘢痕子宫(χ2=118.738,P=0.0010.05)总体呈上升趋势,差异有显著性；社会因素(χ2=26.069,P=0.0010.05)、胎儿窘迫(χ2=6.679,P=0.010.05)总体呈下降趋势,差异有显著性；其余各项指征所占比率各年相比基本持平。 (3)在妊娠合并症及并发症的疾病构成中,构成比由高到低依次为妊娠期高血压疾病、妊娠合并内外科疾病、前置胎盘及胎盘早剥、糖尿病、ICP(Intrahepatic cholestasis of pregnancy,妊娠期肝内胆汁淤积症)。 结论： (1)总体来看,7年间剖宫产率呈下降趋势。 (2)在剖宫产指征构成中,妊娠合并症及并发症成为主要原因,并呈逐渐上升趋势,在妊娠合并症及并发症疾病构成中,妊娠期高血压疾病居于首位,其次依次为妊娠合并内外科疾病、前置胎盘及胎盘早剥、糖尿病、ICP。 (3)社会因素的剖宫产率呈下降趋势。 (4)对胎儿窘迫有了新认识,严格定义胎儿窘迫,故胎儿窘迫的剖宫产率呈下降趋势。 (5)瘢痕子宫的剖宫产率呈上升趋势。
[Abstract]:Objective: cesarean section is an effective method to deal with high-risk pregnancy, abnormal delivery and save the life of pregnant women and perinatal. With the maturity and perfection of various cesarean sections and the development of other related medical fields, the safety of cesarean section has been greatly improved and widely used in clinic. Studies have proved that the increased rate of cesarean section can reduce maternal and perinatal mortality to a certain extent; the rapid development of social economy, the vigorous promotion of family planning, the special value of the fetus, and the lack of confidence in vaginal delivery by pregnant women. The increasing conflicts between doctors and patients and medical disputes, the lack of sound medical laws and regulations have restricted obstetricians from choosing clinical treatment strategies. These factors have made the cesarean section rate in our country the first in the world. It has attracted wide attention in the field of obstetrics at home and abroad. Therefore, to explore the causes of high cesarean section rate and control the cesarean section rate has become the focus of current research. In view of this, this study analyzed the changes of cesarean section rate and indications of cesarean section in seven years, and put forward reasonable measures to control the rate of cesarean section, guiding pregnant women to choose reasonable delivery mode and improve the quality of obstetrics. Methods: the data of 6402 cases of parturient undergoing cesarean section in the first Hospital of Shanxi Medical University from January 2006 to December 2012 were analyzed retrospectively and the changes of cesarean section rate and indications of cesarean section were described. Results: (1) the rate of cesarean section showed a downward trend, and the difference was statistically significant (蠂 ~ 2 / 205.717 / P ~ 0.0010.05). (_ 2). In the changes of indications of cesarean section in 7 years, complications of pregnancy and complications (蠂 ~ (2) 43.906 / P ~ (0.0010.05) and scarred uterus (蠂 ~ (2118.738P ~ 0.0010.05) showed an overall upward trend (蠂 ~ 2118.738P _ (0.0010.05). Social factors (蠂 2 + 26.069) and fetal distress (蠂 2 + 6.679%) showed a decreasing trend (蠂 2 + 6.679%), the difference was significant, and the percentage of other indications was basically the same. (3) in the disease composition of pregnancy complication and complication, there was no significant difference between the two groups. The order of composition ratio from high to low is hypertensive disorder complicating pregnancy, pregnancy with internal and surgical diseases, placenta previa and placental abruption, and intrahepatic cholestasis of pregnancy with diabetes mellitus (ICP (Intrahepatic cholestasis of pregnancy,). Conclusion: (1) the rate of cesarean section has been decreasing in the past seven years. (2) the complications and complications of pregnancy are the main causes of cesarean section. Among the complications and complications of pregnancy, hypertensive disorder complicating pregnancy was the first, followed by pregnancy with internal and surgical diseases, placenta previa and placental abruption. ICP. (3) the cesarean section rate of social factors is decreasing. (4) there is a new understanding of fetal distress, and a strict definition of fetal distress, Therefore, the cesarean section rate of fetal distress decreased. (5) the cesarean section rate of scar uterus increased.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R719.8
[Abstract]:Objective: cesarean section is an effective method to deal with high-risk pregnancy, abnormal delivery and save the life of pregnant women and perinatal. With the maturity and perfection of various cesarean sections and the development of other related medical fields, the safety of cesarean section has been greatly improved and widely used in clinic. Studies have proved that the increased rate of cesarean section can reduce maternal and perinatal mortality to a certain extent; the rapid development of social economy, the vigorous promotion of family planning, the special value of the fetus, and the lack of confidence in vaginal delivery by pregnant women. The increasing conflicts between doctors and patients and medical disputes, the lack of sound medical laws and regulations have restricted obstetricians from choosing clinical treatment strategies. These factors have made the cesarean section rate in our country the first in the world. It has attracted wide attention in the field of obstetrics at home and abroad. Therefore, to explore the causes of high cesarean section rate and control the cesarean section rate has become the focus of current research. In view of this, this study analyzed the changes of cesarean section rate and indications of cesarean section in seven years, and put forward reasonable measures to control the rate of cesarean section, guiding pregnant women to choose reasonable delivery mode and improve the quality of obstetrics. Methods: the data of 6402 cases of parturient undergoing cesarean section in the first Hospital of Shanxi Medical University from January 2006 to December 2012 were analyzed retrospectively and the changes of cesarean section rate and indications of cesarean section were described. Results: (1) the rate of cesarean section showed a downward trend, and the difference was statistically significant (蠂 ~ 2 / 205.717 / P ~ 0.0010.05). (_ 2). In the changes of indications of cesarean section in 7 years, complications of pregnancy and complications (蠂 ~ (2) 43.906 / P ~ (0.0010.05) and scarred uterus (蠂 ~ (2118.738P ~ 0.0010.05) showed an overall upward trend (蠂 ~ 2118.738P _ (0.0010.05). Social factors (蠂 2 + 26.069) and fetal distress (蠂 2 + 6.679%) showed a decreasing trend (蠂 2 + 6.679%), the difference was significant, and the percentage of other indications was basically the same. (3) in the disease composition of pregnancy complication and complication, there was no significant difference between the two groups. The order of composition ratio from high to low is hypertensive disorder complicating pregnancy, pregnancy with internal and surgical diseases, placenta previa and placental abruption, and intrahepatic cholestasis of pregnancy with diabetes mellitus (ICP (Intrahepatic cholestasis of pregnancy,). Conclusion: (1) the rate of cesarean section has been decreasing in the past seven years. (2) the complications and complications of pregnancy are the main causes of cesarean section. Among the complications and complications of pregnancy, hypertensive disorder complicating pregnancy was the first, followed by pregnancy with internal and surgical diseases, placenta previa and placental abruption. ICP. (3) the cesarean section rate of social factors is decreasing. (4) there is a new understanding of fetal distress, and a strict definition of fetal distress, Therefore, the cesarean section rate of fetal distress decreased. (5) the cesarean section rate of scar uterus increased.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R719.8
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