2013~2017年产科剖宫产手术情况及剖宫产指征变化分析
The Situation of Cesarean Section and Changes of Cesarean Section Indication in Obstetrics Department from 2013 to 2017

目的：探讨2013~2017年我院孕产妇剖宫产率及剖宫产指征变化。方法：选择我院2013~2017年分娩的孕产妇52,197例，分析自然分娩产妇和剖宫产产妇的一般人口学特征，比较不同年份的剖宫产率和剖宫产指征。结果：不同年龄的孕产妇剖宫产率差异有统计学意义(P < 0.05)，≥35岁产妇剖宫产率明显高于13~23岁和24~34岁(P < 0.05)。不同住院天数的孕产妇剖宫产率差异有统计学意义(P < 0.05)，住院8~15天和≥15天的产妇剖宫产率明显高于1~3天和4~7天(P < 0.05)。我院剖宫产率为56.28%，2013~2016年呈逐年下降趋势，2017年有所上升。剖宫产指征前3位是瘢痕子宫、胎膜早破、重度子痫。结论：我院剖宫产率仍较高，瘢痕子宫仍是剖宫产的主要原因。
Objective: To investigate the cesarean section rate and changes of indications in the hospital from 2013 to 2017. Methods: 52,197 pregnant and lying-in women who delivered in the hospital from 2013 to 2017 were enrolled in the study. The general demographic characteristics of women un-dergoing natural delivery and cesarean section were compared. The cesarean section rates and ce-sarean section indications in different years were compared. Results: There were significant dif-ferences in cesarean section rate between different age groups (P < 0.05). The cesarean section rate of women ≥ 35 years old was significantly higher than that of women aged 13 - 23 years old and 24 - 34 years old (P < 0.05). There were also significant differences in cesarean section rate between women with different hospital days (P < 0.05). The cesarean section rates of women hospitalized for 8 - 15 days and ≥ 15 days were significantly higher than those hospitalized for 1 - 3 days and 4 - 7 days (P < 0.05). The rate of cesarean section in the hospital was 56.28%. It showed a downward trend year by year from 2013 to 2016 and increased in 2017. The top 3 indications for cesarean section were scarred uterus, premature rupture of membranes and severe pre-eclampsia. Conclu-sion: Cesarean section rate in the hospital is relatively higher and scarred uterus is the main reason for cesarean section.