国际妇产科学杂志

国际妇产科学杂志 ›› 2015, Vol. 42 ›› Issue (3): 358-360.

• 论著 • 上一篇    

降低剖宫产率的干预措施探讨

张宏哲，李树来，任慧   

  1. 300451 天津市滨海新区塘沽妇女儿童保健中心（张宏哲、李树来）；天津市滨海新区卫生和计划生育委员会（任慧）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-06-15 发布日期:2015-06-15

The Intervening Measures on Reducing Caesarean Section Rate

ZHANG Hong-zhe，LI Shu-lai，REN Hui   

  1. Tanggu Women and Children Health Center，Binhai New Area，Tianjin 300451，China（ZHANG Hong-zhe，LI Shu-lai）；Binhai New Area Health and Family Planning Commission，Tianjin 300451，China（REN Hui）
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-06-15 Online:2015-06-15

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摘要： 目的：探讨在保障医疗安全前提下，继续降低剖宫产率的对策。方法：回顾性分析2001—2013年天津市孕产妇保健系统中滨海新区塘沽五家助产机构的全部分娩数据。结果：2001—2008年间剖宫产率由40.09%上升至53.81%达峰值，呈现逐年增高的趋势。通过健康教育、控制孕期体质量增长、加强助产技术培训等降低剖宫产率措施干预，2008—2013年间剖宫产率呈现逐年降低的趋势，2013年剖宫产率下降至37.74%。2001—2008年间社会因素自剖宫产指征第6位逐渐升至第2位，瘢痕子宫升至剖宫产指征首位。结论：加强孕期健康教育及孕妇体质量管理，提高产科医生和助产士的实际操作技能，是降低剖宫产率的有效措施，未来开展剖宫产后阴道分娩是降低剖宫产率的主要干预措施。

关键词: 剖宫产术, 早期干预（教育）, 剖宫产后阴道分娩, 剖宫产指征

Abstract: Objective：Research continued measures to reduce the cesarean section rates under the premise of ensuring medical safety. Methods：Statistically analyzed all the delivery data from Maternal Health Care Management System of five midwifery organizations in Tanggu, Binhai New Area, Tianjin, from 2001 to 2013. Results：Cesarean section rate increased from 40.09% in 2001 to 53.81% (peak rate) in 2008, which was an increasing trend year by year. Undergoing health care, control weight gain during pregnancy and good technique traning, cesarean section rate decreased to 37.74 % in 2013. Cesarean section rate decreased year by year between 2008-2013 . Social factors ranked 6th in cesarean section indications, and gradually increased until 2008 ranked second, uterine scar ranked first in 2013. Conclusions：Processing pregnancy care and control weight gain, improving skills is the effective methods to decrease the rate of cesarean section. In the future, vaginal delivery after cesarean section will be effective prevention methods.

Key words: Cesarean section, Early intervention （education）, Vaginal birth after cesarean, Cesarean section indication