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目的探讨剖宫产率及剖宫产指征的变化和对围产儿死亡率的影响,寻找降低剖宫产率的方法。方法回顾性总结北京市延庆县医院2008年1月至2012年12月住院分娩的病历资料,分析剖宫产率及剖宫产指征变化的各项相关数据和围产儿死亡率的关系。结果 1剖宫产率逐年下降[2012年剖宫产率(39.03%)与2008年(53.94%)相比,P<0.05];2剖宫产指征中以社会因素为指征的剖宫产率通过医护人员的努力得到了有效的控制而下降,随着剖宫产率的下降,产程异常为指征的剖宫产比例增加;3围产儿死亡率趋于稳定,并未随着剖宫产率的下降而升高,2012年围产儿死亡率(3.17‰)与2008年(2.93‰)相比,差异无统计学意义(χ2=0.04,P>0.05)。结论提高助产技术及加强孕期宣教,可进一步降低剖宫产率。
Objective To investigate the changes of cesarean section rate and cesarean section indications and the impact on perinatal mortality and find ways to reduce the rate of cesarean section. Methods The data of medical records of hospital in Yanqing County, Beijing from January 2008 to December 2012 were retrospectively analyzed. The relationship between cesarean section rate and changes of cesarean section indications and perinatal mortality were analyzed. Results 1 The rate of cesarean section decreased year by year [2012 cesarean section rate (39.03%) compared with 2008 (53.94%), P <0.05]; 2 cesarean section indications in social factors as an indication of the cesarean section The rate of births has been effectively controlled and decreased by the efforts of health care workers. As the rate of cesarean section decreases, the proportion of cesarean births that are associated with labor abnormalities has increased. 3 The perinatal mortality rate has not changed with dissection There was no significant difference in the rate of uterine birth (3.17 ‰) in 2012 compared with 2.93 ‰ in 2008 (χ2 = 0.04, P> 0.05). Conclusions Improving midwifery techniques and strengthening prenatal education during pregnancy can further reduce the rate of cesarean section.