摘要
目的分析医院产妇结构改变情况,促进产科医疗质量的提高。方法采用卡方检验和方差分析对2015年1月1日—2020年12月31日产科总的分娩情况,顺产组和剖宫产组中高危因素占比情况,不同年份以及不同高危因素平均年龄进行统计分析。结果6年间顺产分娩6678例,剖宫产分娩11831例,共计18509例,6年内平均剖宫产率高达63.92%;顺产分娩人次呈现先上升后下降的趋势;剖宫产、早产产妇呈下降趋势(P<0.05);双胎妊娠产妇无统计学差异(P>0.05)。顺产组中高龄、妊娠期糖尿病、子痫前期以及试管婴儿产妇呈逐年上升的趋势(P<0.05);剖宫产组中高龄、妊娠期糖尿病、子痫前期、瘢痕子宫、试管婴儿以及产后出血产妇呈现逐年上升趋势(P<0.05)。早产产妇在顺产组和剖宫产组都呈下降趋势(P<0.05)。顺产组、剖宫产组、子痫前期、瘢痕子宫以及试管婴儿产妇平均年龄有随年度递增的趋势(P<0.05);剖宫产组(31.50±4.66)、妊娠期糖尿病组(32.54±4.76)、子痫前期组(31.87±5.43)、瘢痕子宫组(33.50±4.33)、试管婴儿组(32.98±4.37)以及产后出血组(31.96±5.14)产妇的平均年龄均高于顺产组(29.42±4.21)的产妇平均年龄。结论医院需根据产妇剖宫产率高,高危孕产妇占比增多的情况,采取针对性的措施:加强对高危妊娠的早期识别、控制孕妇体重指数、倡导适龄生育、孕产妇进行分类管理等,为降低剖宫产率,改善高危孕产妇妊娠结局而努力。
Objective This study aims to analyze the structural changes of obstetric puerpera,aiming to improve obstetric medical quality.Methods Chi-square test and variance analysis were employed to statistically analyze the overall delivery data in the obstetrics department from January 1,2015 to December 31,2020,including the proportion of high-risk factors in the vaginal delivery and cesarean section groups,as well as the average age across different years and different high-risk factors.Results Over the past six years,there were 6,678 cases of vaginal delivery and 11,831 cases of cesarean delivery,a total of 18 509 cases,with an average cesarean section rate of 63.92%in 6 years.The number of deliveries showed an initial increase followed by a subsequent decline.The proportion of parturients who had undergo cesarean section and those with premature birth showed a downward trend(P<0.05).There was no significant difference in twin pregnancies(P>0.05).The advanced maternal age,gestational diabetes,preeclampsia,and IVF patients showed an increasing trend year by year in the vaginal delivery group(P<0.05).The incidence of advanced maternal age,gestational diabetes,PE,scar uterus,IVF and postpartum hemorrhage among parturients who gave birth by cesarean section increased year by year(P<0.05).The proportion of preterm parturients showed a decreasing trend in both the vaginal delivery and cesarean section group(P<0.05).The average parturients age in the vaginal delivery group,cesarean section group,preeclampsia group,scarred uterus group,and IVF group showed an increasing trend over the years(P<0.05).The average parturients age in the cesarean section group(31.50 ± 4.66),gestational diabetes group(32.54 ± 4.76),preeclampsia group(31.87 ± 5.43),scarred uterus group(33.50 ± 4.33),IVF group(32.98 ± 4.37),and postpartum hemorrhage group(31.96 ± 5.14)was higher than that in the vaginal delivery group(29.42 ± 4.21).Conclusions In response to the high cesarean section rate and the increasing proportion of high-risk pregnant women,hospitals should adopt targeted measures,such as strengthening early identification of high-risk pregnancies,controlling maternal body mass index,promoting childbearing at an appropriate age,and implementing categorized management of pregnant and postpartum women,in order to reduce the cesarean section rate and improve pregnancy outcomes for high-risk pregnant women.
作者
吴莲芝
祝小菁
刘谦
Wu Lianzhi;Zhu Xiaojing;Liu Qian(Department of Obstetrics,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei Province,China;不详)
出处
《中国病案》
2025年第7期43-46,共4页
Chinese Medical Record
基金
湖北省卫健委科研项目(WJ2023F019)。
关键词
产科
结构
统计分析
Obstetrics
Structure
Statistical analysis
