CAJ | 학술논문

目的：分析初产妇无手术指征行剖宫产术的原因，为降低剖宫产率提供依据。方法将640例初产妇分为无手术指征行剖宫产组（观察组）和自然分娩组（对照组），各320例。对产妇一般资料进行分析，比较组间剖宫产可能原因量表、剖宫产及孕期知识量表的差异。结果观察组的平均年龄高于对照组，月收入大于2000元的比例以及受教育程度为大专及以上的比例高于对照组（P＜0．05）。疼痛忍受度、无信心自然顺产、择时生产、家属意愿、高龄产妇方面，观察组均高于对照组（P＜0．05）。观察组孕期知识了解程度低于对照组（P＜0．05）。多因素回归分析显示，受教育程度高（大专及以上学历）、不能忍受疼痛、无信心自然顺产、择时生产、高龄产妇及孕期知识了解程度低，是剖宫产率上升的主要原因。结论对不能忍受疼痛、无信心自然顺产的产妇可采用适当的镇痛及鼓励手段；对择时生产、高龄产妇及孕期知识了解程度低的产妇可加强产妇教育。
목적：분석초산부무수술지정행부궁산술적원인，위강저부궁산솔제공의거。방법장640례초산부분위무수술지정행부궁산조（관찰조）화자연분면조（대조조），각320례。대산부일반자료진행분석，비교조간부궁산가능원인량표、부궁산급잉기지식량표적차이。결과관찰조적평균년령고우대조조，월수입대우2000원적비례이급수교육정도위대전급이상적비례고우대조조（P＜0．05）。동통인수도、무신심자연순산、택시생산、가속의원、고령산부방면，관찰조균고우대조조（P＜0．05）。관찰조잉기지식료해정도저우대조조（P＜0．05）。다인소회귀분석현시，수교육정도고（대전급이상학력）、불능인수동통、무신심자연순산、택시생산、고령산부급잉기지식료해정도저，시부궁산솔상승적주요원인。결론대불능인수동통、무신심자연순산적산부가채용괄당적진통급고려수단；대택시생산、고령산부급잉기지식료해정도저적산부가가강산부교육。
Objective To analyze the reasons of cesarean section in primiparae without operation indications ,in order to provide foundation for reducing the rate of cesarean section .Methods 640 cases of primipara were randomly divided into cesarean section with no operation indications(observation group) and spontaneous labor group(control group) ,320 cases in each each .The general data was investigated and analyzed ,the scale of cesarean section causes ,scale of cesarean section and pregnancy knowledge were compared between the two groups .Results The average age of the observation group was significant higher than that of the control group ,the percentage of monthly income of over 2 000 yuan and the proportion of level of education for college or above was signifi-cant higher than that of the observation group(P<0 .05) .In terms of pain tolerance ,no confidence in the natural delivery ,timing production ,family members will ,elderly parturient women ,the observation group were significant higher than the control group (P<0 .05) .The pregnancy knowledge level of observation group was significant lower than the control group (P<0 .05) .Multi-fac-tor analysis showed that ,high education level ,no tolerence of pain ,no confidence in the natural delivery ,timing production ,elderly parturient women ,and low degree of knowledge during pregnancy were major cause of of cesarean section rate .Conclusion The ap-propriate analgesia and encourage should be adopted for pregnant women who can′t stand the pain ,without confidence in the natural delivery .Education should be strengthen for pregnant women who timing production ,elderly parturient women ,low degree of knowledge .