【摘要】：目的:深入探討濱海新區(qū)剖宮產(chǎn)率的主要影響因素,為進一步降低剖宮產(chǎn)率提供政策依據(jù)。方法:本研究通過定性與定量相結合的研究方法對2014年8月-2014年12月在第五中心醫(yī)院分娩的582名孕產(chǎn)婦進行調查,在孕期各階段對剖宮產(chǎn)的認知程度和其他相關因素進行問卷調查,并采取對醫(yī)生護士等相關人員的深入訪談,對獲取資料進行統(tǒng)計分析。結果:1.此次調查孕產(chǎn)婦的剖宮產(chǎn)率為55.67%(N=324),要比世界衛(wèi)生組織建議的10%一15%的水平高出4-5倍。2.影響孕產(chǎn)婦在懷孕的初期選擇哪種分娩方式的因素主要是孕產(chǎn)婦對剖宮產(chǎn)和順產(chǎn)的認知程度有一定關系;影響孕產(chǎn)婦在分娩前選擇哪種分娩方式的因素主要是在懷孕期間產(chǎn)科檢查醫(yī)生、孕產(chǎn)婦的家長、丈夫及親朋好友、書本、報刊雜志對孕產(chǎn)婦選擇哪種分娩方式提出的一些建議;影響孕產(chǎn)婦在分娩的最后階段選擇哪種分娩方式的因素主要是孕產(chǎn)婦對自己生產(chǎn)的信心及產(chǎn)科醫(yī)護人員對孕產(chǎn)婦分娩方式的建議有非常密切的關系。3.最后通過采用多因素logistic回歸分析的方法,得出對孕產(chǎn)婦最終選擇哪種分娩方式的影響因素主要是以下幾種:孕產(chǎn)婦在最開始懷孕的時候選擇的分娩方式、產(chǎn)科檢查醫(yī)生對孕產(chǎn)婦分娩方式的建議、孕產(chǎn)婦家長丈夫及親朋好友的一些建議、孕產(chǎn)婦對自己生產(chǎn)的信心及在住院期間產(chǎn)科醫(yī)護人員對其分娩方式的建議等影響因素會影響孕產(chǎn)婦最終選擇分娩方式。以上的一些因素對孕產(chǎn)婦后選擇哪種分娩方式的影響是:1.孕產(chǎn)婦在開始懷孕的時候比較傾向于選擇剖宮產(chǎn)的,其最后選擇剖宮產(chǎn)分娩方式的比例要最高。2.產(chǎn)科檢查醫(yī)生對孕產(chǎn)婦提出建議其選擇剖宮產(chǎn)的,其最后選擇剖宮產(chǎn)分娩方式的比例要大于產(chǎn)科檢查醫(yī)生提出建議其選擇自然分娩方式的。結論:中國目前剖宮產(chǎn)率持續(xù)居于高位,其影響因素主要來自醫(yī)學的和社會的各方面原因,比如當前突飛猛進的剖宮產(chǎn)手術技術的發(fā)展、對于實施剖宮產(chǎn)手術指征的不恰當?shù)倪M行人為的擴大、受家長丈夫及親朋好友的影響、孕產(chǎn)婦對于剖宮產(chǎn)手術片面的認識及對自然分娩認知的缺陷、各級醫(yī)療機構產(chǎn)科醫(yī)務人員的助產(chǎn)技術水平不足、社會上的風俗習慣和醫(yī)療衛(wèi)生體制法制建設的不完善。
[Abstract]:Objective: to explore the main influencing factors of cesarean section rate in Binhai New area and to provide policy basis for further reducing cesarean section rate. Methods: a total of 582 pregnant women who gave birth in the Fifth Central Hospital from August 2014 to December 2014 were investigated by qualitative and quantitative methods. The cognitive degree of cesarean section and other related factors were investigated by questionnaire in every stage of pregnancy, and the data were analyzed by in-depth interview with doctors and nurses. The result is 1: 1. The caesarean section rate in the survey was 55.67% (NJ324), 4-5 times higher than the 10% -15% level recommended by the World Health Organization. The main factors that affect the choice of delivery mode in the early pregnancy are the cognitive degree of cesarean section and natural delivery. The factors that influence the choice of delivery mode before delivery are the obstetrical examination doctor during pregnancy, the parents of pregnant women, husband and relatives and friends, books, newspapers and magazines, and some suggestions on which mode of delivery should be chosen by pregnant women; The factors influencing the choice of delivery mode in the final stage of delivery are the confidence of pregnant and lying-in women in their own delivery and the advice of obstetrics and health care workers on the mode of delivery of pregnant and lying-in women. Finally, by using the method of multivariate logistic regression analysis, it is concluded that the main factors influencing the final choice of delivery mode are the following: the mode of delivery that the pregnant women choose at the beginning of pregnancy, Obstetrical examiners' advice on how to give birth to pregnant women, and some advice from parents, husbands, relatives and friends of pregnant women, The influence factors such as maternal confidence in their own delivery and the advice of obstetrics and nurses on their delivery mode during hospitalization will influence the final choice of delivery mode for pregnant women. Some of the above factors on the maternal choice after the birth of the mode of birth is: 1. When pregnant women were more inclined to choose cesarean section at the beginning of pregnancy, the proportion of women who finally chose cesarean section was the highest. 2. The proportion of obstetrical examiners who give advice to pregnant women to choose cesarean section is larger than that of obstetrical examiners who suggest their choice of natural delivery mode. Conclusion: the rate of cesarean section in China continues to be high at present, and the influencing factors mainly come from various reasons of medicine and society, such as the rapid development of cesarean section technology. Under the influence of parents, husbands, relatives and friends, the pregnant and lying-in women have a one-sided understanding of cesarean section and defects in their cognition of natural delivery, because of the improper expansion of the indications of cesarean section, and due to the influence of parents, husbands, and relatives and friends. The technical level of midwifery in obstetrics and obstetrics of medical institutions at all levels is insufficient, and the customs and habits of society and the construction of medical and health system and legal system are not perfect.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R719.8

【參考文獻】

相關期刊論文 前10條

1 班鳳琴;;社會因素剖宮產(chǎn)原因構成分析及預防措施[J];中外醫(yī)學研究;2016年19期

2 吳寒冰;艾玲;曹云飛;王曉霞;王慧華;;剖宮產(chǎn)產(chǎn)婦產(chǎn)后性生活質量及其影響因素調查研究[J];中國性科學;2016年06期

3 田兆華;;剖宮產(chǎn)手術方式對二次婦產(chǎn)科手術的影響探討[J];中國實用醫(yī)藥;2015年30期

4 王麗霞;顧美芹;戚t$紅;呂偉芳;;首次不同剖宮產(chǎn)切口對腹壁、腹腔粘連性及再次剖宮產(chǎn)的影響[J];湖南師范大學學報(醫(yī)學版);2015年05期

5 闕慧;;社會因素剖宮產(chǎn)原因構成分析及預防措施探討[J];醫(yī)學理論與實踐;2015年15期

6 沈淑芬;;基層醫(yī)院社會因素剖宮產(chǎn)原因分析及干預對策[J];中外醫(yī)學研究;2015年17期

7 陳代棠;;非醫(yī)學指征剖宮產(chǎn)的原因及術后護理[J];中國民康醫(yī)學;2014年22期

8 李玲;張立英;羅曉航;呂玉人;;北京朝陽區(qū)剖宮產(chǎn)現(xiàn)狀及影響因素的Logistic回歸分析[J];中國婦幼健康研究;2014年03期

9 張艷梅;王稀琛;李書書;肖雪;張承;嵇曉紅;王守林;;南京某大型醫(yī)院剖宮產(chǎn)及其影響因素的初步分析[J];現(xiàn)代生物醫(yī)學進展;2014年03期

10 裴春紅;;100例社會因素剖宮產(chǎn)的原因構成及干預對策[J];中國醫(yī)藥指南;2013年36期

，

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