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目的:通过分析住院分娩孕产妇资料,了解昆山市中医院剖宫产手术情况、剖宫产原因构成,探讨降低剖宫产率的可行性。方法:将昆山市中医院HIS系统2011~2013年孕产妇信息资料导出,建立Excel数据库,应用SPSS 16.0统计分析软件进行分析。结果:2011~2013年昆山市中医院共收治住院分娩孕产妇10 048名,剖宫产率为41.50%,剖宫产率呈逐年缓慢升高的趋势;剖宫产原因的前5位为瘢痕子宫、胎儿宫内窘迫、无指征剖宫产、胎儿臀位和头盆不称,占67.54%,其中无指征剖宫产的比例为16.30%。分年度看,2011年无指征剖宫产的比例为20.03%,2012年比例为15.29%,2013年比例为13.55%,整体呈下降趋势。但16~23岁孕产妇剖宫产的社会因素百分比明显高于≥35岁孕产妇的社会因素百分比,差异具有统计学意义(P<0.01)。结论:昆山市中医院剖宫产率仍较高,同时低年龄孕产妇剖宫产的社会因素构成比高于高龄孕产妇。建议采取加强宣教、开办孕妇学校、提高医师医疗水平等综合措施,强化产前检查和沟通,提高孕产妇对阴道分娩的接受度,降低剖宫产率。
Objective: To analyze the cesarean section of Kunshan Hospital of Traditional Chinese Medicine by analyzing the data of maternal and childbirth in hospital, and to analyze the causes of cesarean section and to explore the feasibility of reducing cesarean section rate. Methods: The information of pregnant women in HIS system of Kunshan Hospitals from 2011 to 2013 was derived. The Excel database was established and analyzed by SPSS 16.0 statistical analysis software. Results: From 2011 to 2013, Kunshan Hospital of Traditional Chinese Medicine received a total of 10 048 maternal births, cesarean section rate was 41.50%, cesarean section rate showed a slowly increasing trend year after year; cesarean section reasons for the first five were scar Uterus, fetal distress, cesarean without indications, fetal breech and cephalopelvic disproportion, accounting for 67.54%, of which cataracts without indication was 16.30%. According to the annual statistics, the rate of cesarean section without indication was 20.03% in 2011, 15.29% in 2012 and 13.55% in 2013, showing an overall downward trend. However, the percentage of social factors of cesarean section among males aged 16 to 23 was significantly higher than that of males ≥35 years (P <0.01). Conclusion: The rate of cesarean section in Kunshan Hospital of Chinese Medicine is still high, while the social factor of cesarean section in low-age pregnant women is higher than that of older pregnant women. It is suggested to take comprehensive measures such as strengthening education, starting pregnant women schools and improving the level of medical care of doctors, strengthening prenatal screening and communication, improving maternal acceptance of vaginal delivery, and reducing the rate of cesarean section.