【摘要】 目的　剖析近年来剖宫产率居高不下的主要影响因素 ,为制定降低剖宫产率的具体措施提供资料。方法　对 1989年至 2 0 0 1年间吉林大学第二医院产科住院产妇的足月分娩病例进行回顾性分析。结果　①剖宫产率呈逐年上升趋势 ,而产钳率呈逐年下降趋势 ;②剖宫产占难产分娩的比例逐年增高 ,同期产钳助产占难产分娩的比例逐年下降 ;③ 2 0 0 0年以前居于前四位的剖宫产手术指征是 :相对头盆不称、胎儿窘迫、臀位、胎膜早破 ;1999年起珍贵儿指征已出现 ,2 0 0 0年及 2 0 0 1年已跃居第二位 ;④ 2 0 0 0年与 2 0 0 1年脐带绕颈作为剖宫产指征居于第五位和第六位 ;⑤因单因素指征行剖宫产的比例逐年增加 ,而因多因素指征行剖宫产的比例逐年下降。结论　现今 ,剖宫产手术指征已远远超过单纯医学指征的范围 ,来自孕产妇及医生的主观意愿影响着对分娩方式的合理选择。更多还原

【Abstract】 Objective To provide data for determining means to reduce cesarean section rate.Methods We retrospectively studied the cases of mature delivery from 1989 to 2001 in our hospital. Results ① The rate had increased gradually year after year since 1993,whereas there was a downward trend of forceps delivery rate in those thirteen years. ② The ratio of cesarean section birth to dystocia delivery increased year after year,while that of forceps delivery to dystocia delivery decreased. ③ The major indications of cesarean section from 1989 to 1999 were relative cephalopelvic disproportion, fetal distress, breech presentation and premature rupture of membranes.Precious fetus had been the second indication from 2000 to 2001.④ The indication of nuchal cord rose to be the fifth in 2000 and the sixth in 2001.⑤ The cases with a single indication had increased gradually and those with multiple indications had decreased accordingly. Conclusion The operation indications of cesarean section are beyond medical concerns now.The subjective thought of gravida and doctors weakens the rational decisions about the way of delivery.更多还原