不同年代剖宫产率及剖宫产指征的变化

目的 分析近年来剖宫产率上升的原因及其指征的变化，为降低剖宫产率提供依据。方法 对1980～1984年、1990～1994年、2000～2004年福建医科大学第二附属医院分娩的28522例，其中剖宫产8366例的产妇资料进行分析。结果 剖宫产率呈逐年上升趋势，2000～2004年已上升到47．7％；头盆不称及胎儿宫内窘迫一直位居剖宫产指征前2位；社会因素已跃居第3位；胎膜早破及脐带绕颈居第4位和第5位。结论 剖宫产指征已远远超过医学指征范围，孕产妇及医生的主观意愿影响对分娩方式的合理选择。因此，加强孕产期保健及对产妇和家属的宣教工作，严格掌握剖宫产指征，将有助于降低剖宫产率。

Trends of cesarean section rate and the indication for cesarean rection

Objective To provide data for determining means to reduce cesarean section rate. Methods 8 366 cesarean section cases among 25 522 deliveries in our hospital from 1980 to1984,1990 to 1994,and 2000 to 2004 were analyzed retrospectively. Results There was a steady increase in the rate of cesarean section during the study period and reached to 47.7 % in 2000-2004. Cepha]opolvic dis- proportion and fetal distress rank first and second, respectively, in indications of cesarean section. Social factors were the third indication. Premature rupture of membranes and nuchal cord rose to be the fourb and the fifth in 2000-2004. Conclusion The operation indications of cesarean section are beyond medical concerns now. The subjective thought of women and doctors weakens the rational decisions about the way of delivery. Education to women and their families is indicated to curb the increase of cesarean secion.