综合干预措施降低剖宫产率研究

摘要

Objective To take comprehensive intervention measures to promote vaginal delivery,and to explore the reduction of cesarean section rate to improve the quality of obstetric methods.Methods Implement and improve the comprehensive intervention measures gradually,and analyze the clinical data of the patients who received health examination and delivered in the Fourth Hospital of Shijiazhuang from Jan.2010 to Dec.2014.Results In the 5 years,the average cesarean section rate was 34.48％,dropping from 38％ in 2010 to 31.99％ in 2014,the difference being statistically significant (P＜0.05).(2) Cesarean section of the indications constitute a significant change in the composition of social factors decreased year by year,the first one in 2010 fell to 2014,the first six,the scarred uterus from the second were promoted to the first.Taking the comprehensive intervention measures to reduce the rate of cesarean section did not affect quality of obstetrics,5 years,our hospital maternal mortality rate of zero,postpartum hemorrhage rate of 0.78％,the average rate of 5.30％,neonatal asphyxia rate of 0.43％.Conclusion To comprehensive interventions taken by our hospital can effectively reduce the rate of cesarean section,especially in the control of social factors cesarean section effect is remarkable,the results of this study should be extended to the majority of grass-roots midwifery institutions,in order to improve the province and the countrywide obstetric quality,baby well-being.%目的 探讨采取综合干预措施促进阴道分娩、降低剖宫产率、提高产科质量的有效方法.方法 逐步实施并改进综合干预措施,观察分析2010年1月至2014年12月在石家庄市第四医院保健与分娩患者的临床资料.结果 5年间,平均剖宫产率为34.48％,剖宫产率由2010年的38％下降为2014年的31.99％,剖宫产率比较差异有统计学意义(P＜0.05).剖宫产手术指征构成比发生了明显变化,社会因素逐年下降,由2010年的第1位逐年下降为2014年的第6位;瘢痕子宫由第2位升为第1位.采取综合干预措施降低剖宫产率并没有影响产科质量,5年间孕产妇死亡率为0,产后出血率为0.78％,平均助产率为5.30％,新生儿窒息率为0.43％.结论 采取综合干预措施可有效降低剖宫产率,尤其在控制社会因素剖宫产方面效果显著,值得向广大基层助产机构推广.