目的:探讨剖宫产指征的变化及剖宫产率上升的循证评价.方法:本文研究了我院2000～2009年这10年间剖宫产构成比与围生儿死亡率的关系,并通过循证医学探讨降低剖宫产率的方法.结果:剖宫产率呈现逐年上升趋势,从2000年的4.63%上升至2009年的12.34%,差异具有高度统计学意义(P<0.01).巨大儿剖宫产率则由45.00%上升至72.92%,差异具有高度统计学意义(P<0.01).社会因素是2000～2009年里变化最明显的一个剖宫产指征.结论:剖宫产率上升与巨大儿发生率上升有关,更与非医学指征的社会因素有关.%Objective: To investigate the evidence-based evaluation on the changes of cesarean section rate and the rise of its indication. Methods: The relationship between the constituent ratio of cesarean section and the perinatal mortality from 2000 to 2009 was discussed by this paper, and the method of how to reduce the cesarean section rate was discussed by the evaluation of evidence-based medicine. Results: The cesarean section rate showed an increasing trend year by year, from 4.63％ in 2000 to 12.34％ in 2009, and the difference was statistically significant (P＜0.01). Great children cesarean section rate increased from 45.00％ to 72.92％, and the difference was statistically significant (P＜0.01). Social factor was one of the most obvious indications of cesarean section from 2000 to 2009. Conclusion: The rise of cesarean section rate has relationship with the rising incidence of large children, and also has relationship with non-medical indications social factors.
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