生育政策下剖宫产率及剖宫产指征变化的分析
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摘要
目的分析二孩政策前后,北京市顺义区妇幼保健院的剖宫产率及剖宫产指征的变化。方法选取北京市顺义区妇幼保健院妇产科2015年1月—2017年12月20 835例产妇的病例资料,分为2015年、2016年及2017年3组进行回顾性分析。结果 2015年、2016年及2017年,该院剖宫产率分别为36.92%、34.64%和38.35%,差异有统计学意义(P<0.05)。其中,瘢痕子宫指征位于首位,分别为36.64%、41.06%、50.30%,逐年增加,差异有统计学意义(χ~2=78.42,P<0.05)。社会因素指征剖宫产所占比例分别为3.89%、3.06%、2.13%,2017年明显低于2016年(χ~2=12.17,P<0.05)。结论二孩生育政策前后,该院的剖宫产率从2015—2016年稍有下降,2017年有上升趋势,社会因素指征所占比例显著降低。积累和探索经阴道分娩的剖宫产术后临床病例是今后需要解决的问题。
Objective To analyze the cesarean section rate and changes of cesarean section signs under the family planning policy in the Shunyi District Maternal and Infant Healthcare Hospital. Methods 20 835 cases of delivery women in our hospital from January 2015 to December 2017 were selected and divided into three groups, including the group in 2015, the group in 2016 and the group in 2017. Results The cesarean section rates in 2015, 2016 and 2017 were respectively 36.92%, 34.64%, 38.35%, and the differences were statistically significant(P<0.05), and the scar uterus indication was in the first place, respectively accounting for 36.64%, 41.06%, 50.30%, increasing year by year,and the difference was statistically significant(χ~2=78.42, P <0.05), and the social factor sign cesarean section ratios were respectively 3.89%, 2.26%, 2.13%, and the index in 2017 was obviously lower than that in 2016(χ~2=12.17, P<0.05). Conclusion The cesarean section rate in our hospital decreases slightly from 2015 to 2016 before and after the second-child family planning policy, the indicator in 2017 shows an increasing trend, and the proportion of social factor signs obviously decreases, and the clinical cases with vaginal delivery after the cesarean section is the first problem in future.
Objective To analyze the cesarean section rate and changes of cesarean section signs under the family planning policy in the Shunyi District Maternal and Infant Healthcare Hospital. Methods 20 835 cases of delivery women in our hospital from January 2015 to December 2017 were selected and divided into three groups, including the group in 2015, the group in 2016 and the group in 2017. Results The cesarean section rates in 2015, 2016 and 2017 were respectively 36.92%, 34.64%, 38.35%, and the differences were statistically significant(P<0.05), and the scar uterus indication was in the first place, respectively accounting for 36.64%, 41.06%, 50.30%, increasing year by year,and the difference was statistically significant(χ~2=78.42, P <0.05), and the social factor sign cesarean section ratios were respectively 3.89%, 2.26%, 2.13%, and the index in 2017 was obviously lower than that in 2016(χ~2=12.17, P<0.05). Conclusion The cesarean section rate in our hospital decreases slightly from 2015 to 2016 before and after the second-child family planning policy, the indicator in 2017 shows an increasing trend, and the proportion of social factor signs obviously decreases, and the clinical cases with vaginal delivery after the cesarean section is the first problem in future.
引文
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[2]包春荣,余自成,丁佩芳,等.全面二孩政策实施前后剖宫产率、妊娠并发症和不良妊娠结局的变化[J].中国妇幼保健,2018,33(4):724-726.
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[7]潘旭梅.剖宫产术后再次阴道分娩可行性分析[J].中外医学研究,2016,14(3):146-147.
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[9]American College of Obstetricians and Gynecologists'Committee on Practice Bulletins Obstetrics.Practice Bulletin No.161:External Cephalic Version[J].Obstet Gynecol,2016,127(2):54-61.
[10]邓新琼,覃晓慧,廖滔,等.足月单胎臀位外倒转术的可行性及影响因素分析[J].中国妇幼保健,2017,32(11):2476-2479.
[11]马翠,赵友萍.75例臀位外倒转术临床分析[J].医学研究杂志,2016,45(12):102-104.
[12]周水生,梁德阳.臀位外倒转术的临床应用[J].中华产科急救电子杂志,2017,6(4):246-247.
[13]王晓怡,黄赟博,林琳,等.单胎臀位外倒转术的影响因素分析[J].中华产科急救电子杂志,2016,5(2):110-113.
[14]刘洪慧.控制剖宫产率前后的手术指征变化分析[J].中国医药科学,2014,4(5):76-78.
[2]包春荣,余自成,丁佩芳,等.全面二孩政策实施前后剖宫产率、妊娠并发症和不良妊娠结局的变化[J].中国妇幼保健,2018,33(4):724-726.
[3]中华医学会妇产科学分会产科学组.剖宫产术后再次妊娠阴道分娩管理的专家共识(2016)[J].中华妇产科杂志.2016,51(8)561-564.
[4]张丽萍,杨玉娇,曾雯琼,等.剖宫产术后再次妊娠经阴道分娩成功的因素及母婴结局分析[J].实用临床医药杂志,2018,22(7):78-81.
[5]张雅娟.剖宫产术后再次妊娠阴道分娩成功的影响因素及母婴结局分析[J].中国现代医生,2016,54(35):47-50.
[6]王倩,沙小龙.瘢痕子宫再次妊娠经阴道分娩可行性研究[J].中国现代医生,2016,54(3):41-43.
[7]潘旭梅.剖宫产术后再次阴道分娩可行性分析[J].中外医学研究,2016,14(3):146-147.
[8]卢峰.剖宫产术后再次妊娠阴道分娩的临床分析[J].中外医学研究,2016,14(3):147-148.
[9]American College of Obstetricians and Gynecologists'Committee on Practice Bulletins Obstetrics.Practice Bulletin No.161:External Cephalic Version[J].Obstet Gynecol,2016,127(2):54-61.
[10]邓新琼,覃晓慧,廖滔,等.足月单胎臀位外倒转术的可行性及影响因素分析[J].中国妇幼保健,2017,32(11):2476-2479.
[11]马翠,赵友萍.75例臀位外倒转术临床分析[J].医学研究杂志,2016,45(12):102-104.
[12]周水生,梁德阳.臀位外倒转术的临床应用[J].中华产科急救电子杂志,2017,6(4):246-247.
[13]王晓怡,黄赟博,林琳,等.单胎臀位外倒转术的影响因素分析[J].中华产科急救电子杂志,2016,5(2):110-113.
[14]刘洪慧.控制剖宫产率前后的手术指征变化分析[J].中国医药科学,2014,4(5):76-78.