中国与突尼斯同级医院产妇基本情况及产科环境对分娩结局的影响分析

目的探讨和借鉴不同国家的产科优势技术，达到降低剖宫产率提高阴道分娩率。方法对2008年9月至2009年8月在中国江西吉安妇幼保健院和突尼斯西迪-布吉德省立医院分娩的5848例孕37-41±6周的产妇分娩资料进行回顾性分析。结果吉安妇保初产妇占82．51％，西迪医院初产妇占35．70％，存在统计学意义（P〈0．01）；产科环境截然不同。在两国产妇对分娩方式的选择上，吉安妇保的产妇拥有知情权，西迪医院10％的产妇拥有知情权；剖宫产技术被广泛使用，剖宫产率均高于WHO的标准。不包括会阴切开缝合术的阴道助产技术实施情况为，吉安妇保为3．10％（25／807），西迪医院为17．01％（581／3415），两家医院比较，差异显著（P〈0．01）。结论分娩产次和宽松的医疗环境，以及熟练的阴道助产技术．是保证阴道分娩成功的关锌．

Analysis of effect of general situations of delivery women and obstetrical surroundings on delivery result in the same rank Hospitals between China and Tunis

Objective：Using the superior obstetrical techniques in different countries to decrease the rate of cesarean section（C-sect） and promote vaginal delivery rate. Methods： Clinical data of 5848 parturients in the Jian Maternity and Child Healtheare Hospital and the Tunisia Sidi-Buji De Provincial and Municipal Hospital of Tunis from Sep 2008 to Aug 2009 were analyzed retrospectively. Results：The rate of primipara in Jian Hospital was 82.51 percent, while in Tunisia Hospital was only 35.70 percent（P〈0.01）. The dif- ferent surroundings of obstetrical department can be reflected in the decision rights of the delivery mode. The parturients in Jian hospital all had the fight to know, while only 10 percent of parturients in Tunisia hospital had the fight to know. The technology of C-sect was extensively used, and the rates of C-sect in China and Tunis both were higher than the standard of WHO. The performance of vaginal delivery tech- niques without including perineotomy-rrhaphy was 3.10 percent （25/807） in Jian, 17.01 percent （581/3415） in Tunis. Conclusion： The times of labor, relaxed curing environment and proficient vaginal delivery tech- niques were the key to guarantee the success of vaginal delivery.