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目的:探讨基层剖宫产率升高的原因为有效控制基层剖宫产率上升。方法:对201所县及县以上医疗保健机构的定量资料进行描述性研究,在抽查的4个县2010~2012年定量资料分析基础上对相关医疗保健机构9所的助产工作现状进行定性研究。结果:基层医疗保健机构的剖宫产率从2006年29.23%上升至2012年的35.31%,最高的达61.47%,上升速度大于省市两级。从4个县抽样病历25份中无剖宫产指征2例、社会因素1例,占12.00%。孕期系统保健服务仅47.50%。结论:加大对不合理剖宫产的监管力度,将剖宫产率列为产科质量考核的指标,减少不合理剖宫产。
Objective: To investigate the reason for the increase of cesarean section rate in primary level to effectively control the rise of cesarean section rate. Methods: The quantitative data of 201 health care institutions at or above the county level were descriptively studied. Based on the quantitative data analysis of 4 counties from 2010 to 2012, the status of midwifery in 9 health care institutions was qualitatively studied . Results: The rate of cesarean section in primary health care institutions rose from 29.23% in 2006 to 35.31% in 2012, the highest was 61.47%, which was higher than the provincial and municipal levels. There were no cesarean indications in 25 out of 4 counties, and 1 social factor (12.00%). System health services during pregnancy only 47.50%. Conclusion: To increase the supervision of unreasonable cesarean section, cesarean section rate as obstetric quality assessment indicators to reduce unreasonable cesarean section.