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目的:分析剖宫产率及剖宫产因素的变化趋势。方法:回顾性分析漯河医学高等专科学校第三附属医院1981～2008年的孕产妇临床资料,以5年时间为段距,计算不同时期剖宫产与阴道产的构成比,比较胎儿、母亲、头盆不称和非医学指征4个剖宫产指征的变化趋势。结果:①剖宫产率由1981～1985年的13.33%上升到2006～2008年的33.79%,阴道助产率和自然分娩率均呈下降趋势,不同时间段分娩方式的差异有统计学意义(P<0.05)。②剖宫产非医疗指征构成比由1981～1985年间的17.12%上升到2006～2008年间的36.74%,呈逐年增加趋势,已成为剖宫指征首位因素;而医学因素(胎儿因素、母亲因素、头盆不称)则有下降趋势,在1981～2000年间首位剖宫指征因素一直是头盆不称,2001年后成为第2位因素。结论:剖宫产率呈逐年升高趋势。剖宫产因素也由单纯的医学因素转变为医学因素和非医学因素并存,且非医学因素呈迅速膨胀趋势。制定由社会、产妇、医生共同参与的优生计划势在必行。
Objective: To analyze the trend of cesarean section rate and cesarean section. Methods: The clinical data of pregnant women in the Third Affiliated Hospital of Luohe Medical College from 1981 to 2008 were retrospectively analyzed. The five-year intervals were used to calculate the constituent ratio of cesarean section and vaginal discharge in different periods. Fetal, Variation of indications of cesarean section in 4 cases with cesarean section and non - medical indications. Results: ① The rate of cesarean section increased from 13.33% in 1981 ~ 1985 to 33.79% in 2006 ~ 2008. The vaginal delivery rate and spontaneous delivery rate all showed a decreasing trend. The differences of delivery mode in different time periods were statistically significant ( P <0.05). ② The proportion of cesarean section non-medical indications increased from 17.12% in 1981 ~ 1985 to 36.74% in 2006 ~ 2008, showing an increasing trend year by year and has become the first factor of cesarean section indications; and medical factors (fetal factors, mothers Factors, cephalopelvic disproportion) there is a downward trend in the first cesarean section in 1981 and 2000, the index has been the index of cephalopelvic disproportion, after 2001 as the second factor. Conclusion: The rate of cesarean section showed an increasing trend year by year. Cesarean section factors also changed from simple medical factors to medical factors and non-medical factors, and non-medical factors showed a rapid expansion trend. It is imperative to draw up an eugenics program involving the community, mothers and doctors.