摘要
目的:探讨大连市初产妇及经产妇剖宫产率现状及剖宫产手术指征构成,为大连市剖宫产率控制提供循证学依据。方法:收集大连市8家综合和妇幼专科医院2021年全年分娩资料,计算总剖宫产率,并比较不同级别、不同性质和不同城区医院剖宫产率的差异。分析二级医院及三级医院初产妇与经产妇剖宫产率及剖宫产手术指征构成。结果:8家医院的总剖宫产率为42.16%(7219/17123)。近郊和远郊医院的剖宫产率明显高于中心城区医院(45.13%、47.78%vs 38.87%,P<0.01),二级医院的剖宫产率高于三级医院(44.20%vs 41.37%,P<0.01),综合医院的剖宫产率高于专科医院(47.10%vs 40.42%,P<0.01)。三级医院的初产妇剖宫产率高于二级医院(40.63%vs 38.29%,P<0.05),经产妇剖宫产率明显低于二级医院(43.12%vs 52.55%,P<0.01)。三级医院初产妇剖宫产指征占比首位为高龄初产(12.50%),二级医院为无医学指征(23.44%)。二级医院及三级医院经产妇剖宫产指征占比首位均为瘢痕子宫(87.13%和79.60%)。结论:大连市剖宫产率处于较高水平,不同特征医院之间剖宫产率均存在明显差异;不同级别医院之间初产妇与经产妇剖宫产率及剖宫产指征占比均存在差异。高龄初产及无医学指征占初产妇剖宫产指征比重高;瘢痕子宫占经产妇剖宫产指征比重高。
Objective:To study the current status of cesarean section rate(CSR)and cesarean section(CS)indications of primipara and multiparain in Dalian,and to provide an evidence-based basis for the control of cesarean section rates.Methods:Eight general and maternal and child hospitals in Dalian were selected,and all data of childbirth of these hospitals in 2021 were collected.The total CSR was calculated for all hospitals and the CSR among different hospitals was compared.The CSR and constitution of CS indications of primipara and multiparain were analyzed.Results:The total CSR of all hospitals was 42.16%.The CSR in suburbs and outer suburbs hospitals were significantly higher than that in city center(45.13%、47.78%vs 38.87%,P<0.01).The CSR in secondary hospitals was significantly higher than that in tertiary hospitals(44.20%vs 41.37%,P<0.01).The CSR in general hospitals was higher than that in maternal and child hospitals(47.10%vs 40.42%,P<0.01).The CSR of primipara in tertiary hospitals was higher than that in secondary hospitals(40.63%vs 38.29%,P<0.05).The CSR of multipara in secondary hospitals was significantly higher than that in tertiary hospitals(52.55%vs 43.12%,P<0.01).The top one CS indications was 12.50%for senior primigravida of primipara in tertiary hospitals,while the 23.44%for no medical indications in secondary hospitals.The top one CS indications of multipara both in secondary and tertiary hospitals was scarred uterus(87.13%,79.60%).Conclusion:The CSR in Dalian is at a high level.There are significant differences in CSR among different hospitals.The CSR and constitution of CS indications of primipara and multiparain in different levels hospitals are different.The senior primigravida and no medical indications are the leading causes of CS in primipara,while in multipara is the scarred uterus.
作者
徐晓明
王傲
李玉岩
Xu Xiaoming;Wang Ao;Li Yuyan(Dalian Medical Center For Women And Children,Dalian 116033)
出处
《现代妇产科进展》
北大核心
2023年第6期438-441,共4页
Progress in Obstetrics and Gynecology
基金
2021年大连市医学科学研究计划项目-医学软科学类项目(No:2122002)。
关键词
大连市
初产妇
经产妇
剖宫产率
剖宫产指征
Dalian city
Primipara
Multipara
Cesarean section rate
Cesarean section indications
