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目的分析探讨以胎儿窘迫为指征而行剖宫产术诊断的准确性及手术的合理性,降低以胎儿窘迫为指征的剖宫产率。方法对1993年10月至2003年10月间416例以胎儿窘迫为指征的剖宫产病例资料进行回顾性分析。结果以胎儿窘迫为指征者占剖宫产总数的20.90%,居首位。术前术后胎儿窘迫诊断符合率较低,表明对胎儿窘迫存在有诊断过度的问题,提示有一部分不合理的操之过急的剖宫产存在,缺乏合理性,诊断标准欠妥当。单纯根据胎心率或羊水情况诊断胎儿窘迫欠妥当,而胎心监护仪准确度亦有一定局限性。结论诊断胎儿窘迫尚需多方面其他因素综合判断,采用产前多项指标联合监测及产时全程监护方法,探索医学规范的评判标准,结合孕妇的具体情况进行全面分析,提高胎儿窘迫的诊断符合率。正确掌握剖宫产指征,降低剖宫产率。
Objective To analyze the accuracy of the diagnosis of cesarean section with fetal distress and the rationality of operation, and to reduce the rate of cesarean section with fetal distress as the indication. Methods A retrospective analysis of 416 cases of cesarean section with fetal distress was performed from October 1993 to October 2003. Results Fetal distress as an indicator of total cesarean section accounted for 20.90%, ranking first. Preoperative and postoperative fetal distress diagnosis coincidence rate is low, indicating that there is a diagnosis of fetal distress excessive problems, suggesting that there is an unreasonable part of the emergency cesarean section, the lack of rationality, diagnostic criteria inappropriate. Fetal heart rate alone or amniotic fluid based on the diagnosis of fetal distress is not properly, and the accuracy of fetal heart rate monitor also has some limitations. Conclusion The diagnosis of fetal distress still need comprehensive judgment of many other factors, the use of multiple indicators of prenatal care combined with monitoring and full time monitoring method to explore the medical standard of evaluation criteria, combined with the specific situation of pregnant women to conduct a comprehensive analysis to improve the diagnosis of fetal distress compliance rate. Proper cesarean indications, reduce cesarean section rate.