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目的探讨剖宫产率升高原因及降低剖宫产率的措施。方法对门头沟区医院妇产科2010年1月至10月一胎足月分娩的502例孕妇的临床资料进行回顾性分析,比较不同时期剖宫产率和剖宫产手术指征的变化。结果 502例孕妇中有49.20%(247例)孕妇采用剖宫产手术的方式,选择剖宫产手术原因有:10.53%孕妇是由于妊娠并发症、合并症的影响;9.31%由于臀位的影响;2.43%由于胎儿窘迫的影响;14.57%由于难产的影响,包括产程异常、胎头位置异常、头盆不称、倾斜骨盆、骨盆狭窄等;40.08%由于社会因素的影响;4.86%由于巨大儿的影响;18.22%由于其它因素的影响包括单脐动脉、脐动脉高阻、过期妊娠、胎膜早破等。结论剖宫产手术指征中社会因素的降低可通过加强护理干预来完成,具有较好的临床实践意义,只有医务人员、家庭、社会、孕妇等的共同努力,才能降低社会因素剖宫产率,创造合理的分娩环境,控制剖宫产率的上升。
Objective To investigate the causes of increased cesarean section rate and measures to reduce the rate of cesarean section. Methods A retrospective analysis was performed on the clinical data of 502 pregnant women with full-term birth delivered from January 2010 to October 2010 in Mentougou District Hospital. The changes of cesarean section rate and cesarean section indications during different periods were compared. Results Among the 502 pregnant women, 49.20% (247 cases) underwent cesarean section. The causes of cesarean section were as follows: 10.53% of pregnant women were due to pregnancy complications and complications; 9.31% ; 2.43% due to fetal distress; 14.57% due to the effects of dystocia, including labor abnormalities, abnormal fetal head position, the first basin is not known, tilted pelvis, pelvic stenosis, etc .; 40.08% due to social factors; 4.86% 18.22% due to other factors, including single umbilical artery, umbilical artery resistance, prolonged pregnancy, premature rupture of membranes and so on. Conclusion The reduction of social factors in indications of cesarean section can be accomplished by strengthening nursing intervention, which has a good clinical practice meaning. Only the joint efforts of medical staff, family, society and pregnant women can reduce the social factors of cesarean section rate , To create a reasonable delivery environment, control the rise in cesarean section rate.