5 106例剖宫产手术剖宫产率、指征及母儿预后分析

目的分析剖宫产率升高的原因及指征的变化以及指征与母儿预后的关系。方法对5106例剖宫产手术病例进行回顾性分析。结果平均剖宫产率33.9%,剖宫产率逐年在增加,1995年为25.78%,2003年为43.8%,2004年为40.91%,前后5年间差异有显著性(P<0.001〉。其中以社会因素及胎儿窘迫为指征的剖宫产率增加显著,两组间差异有高度显著性(P<0.01)。剖宫产的上升,围产儿窒息及死亡率并没有明显下降,且在择期剖宫产手术中,子宫切除率及产后出血率较阴道试产后手术组为高。结论剖宫产并不是绝对安全的分娩方式,剖宫产率的升高并没有明显降低围产儿窒息及死亡率。并且,择期剖宫产术的母儿预后较临产后手术母儿预后为差。剖宫产率的上升因素中以社会因素及胎儿窘迫变化最大,因此,剖宫产率的增加已不是一个单纯的医疗问题,而是一个社会问题,应引起广大社会和专家的关注。

Rate,indications and expectancy of cesarean section during:5 106 cases

Aim To analyze causes for increase in cesarean section rate and changes of indications.Methods The medical records for cesarean section of 5 106 cases were retrospectively analyzed.Results The average rate of cesarean section was 33.9%.It went up from 25.78% in 1995 to 40.91% in 2004(P<0.001).The society factor was taken in operative indications.Its rate increased obviously from 12.4% in 1995 to 37.4% in 2004(P<0.001).The perinatal death rate did not descend notably while the cesarean section rate rose.WTHZ]Conclusions The cesarean section is not an absolute safe mode of delivery.It is not only a medical problem concerning cesarean section rate,but also a social problem.It should be paid close attention to by specialists and the whole society.