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[关键词] 产科；自然分娩；剖宫产率；护理新模式；满意度
The influence of new nursing mode on promoting natural delivery and reducing the rate of cesarean section
Li Jing
(obstetrics department, Huangpi District People's Hospital, Wuhan, Hubei 430300)
[Abstract] Objective: To study and analyze the application value of the new nursing mode to promote the natural delivery of pregnant women. Methods: 116 pregnant women who delivered in our hospital from May 2018 to October 2019 were randomly selected. The subjects were randomly divided into two groups: routine nursing group and new mode nursing group, 58 cases in each group. The subjects in the two groups received two different nursing modes, routine nursing and new mode nursing respectively. The influence of nursing service on the delivery outcome of the two groups was statistically analyzed and compared In order to reflect the application effect of the new mode of nursing, the active period, the time of the first stage of labor, the time of the second stage of labor, the amount of bleeding and the degree of satisfaction of the parturient were studied. Results: in the routine nursing group, there were 53 cases of natural childbirth and 5 cases of cesarean section, the cesarean section rate was 8.62%. Among them, the active period of natural childbirth was (23.36 ± 2.85) h, the first stage was (23.29 ± 3.46) h, the second stage was (0.91 ± 0.25) h, and the amount of bleeding during childbirth was (211.07 ± 13.46) ml; in the new mode nursing group, 57 cases of natural childbirth and 1 case were studied The cesarean section rate was 1.72%, in which the active period of natural delivery subjects was (21.58 ± 3.14) h, the first stage of labor was (19.98 ± 2.76) h, the second stage of labor was (0.79 ± 0.55) h, and the amount of bleeding during labor was (186.32 ± 16.25) ml; 56 subjects in the conventional nursing group were "satisfied" with nursing services, and the satisfaction rate was 96.55%. 49 subjects in the new mode nursing group were "satisfied" with nursing services Compared with the conventional nursing group, the new mode nursing group had lower cesarean section rate, shorter active period, first stage and second stage of labor, less bleeding during labor, higher satisfaction and statistical significance (P < 0.05). Conclusion: compared with routine nursing, the new mode of nursing can significantly reduce the rate of cesarean section, shorten the active period, the first stage and the second stage of delivery, and reduce the amount of bleeding during delivery.
[Key words] obstetrics; natural delivery; cesarean section rate; new nursing mode; satisfaction
剖宫产术可能引起瘢痕子宫等情况，在分娩状况允许的情况下，临床上鼓励产妇进行自然分娩[1]。对于孕产妇采取适当的护理方式旨在促进其自然分娩，消除患者焦虑不安等情绪，并减少分娩过程中孕产妇的疼痛和出血[2]。本研究随机抽取在我院进行分娩的孕妇进行随机分组，分别给予常规护理和新模式护理两种不同的护理模式，统计分析护理服务对于两组研究对象分娩结局的影响，反映护理新模式的应用效果。
1 资料与方法
1.1 研究对象基本资料
从2018年5月-2019年10月期间在我院进行分娩的孕妇中随机选取116人，将研究对象随机分为常规护理组和新模式护理组，每组58例，两组研究对象分别接受常规护理和新模式护理两种不同的护理模式。两组研究对象基本资料差异无统计学意义，保证了分组过程中的抽样随机造成的误差不会影响研究结果。
1.2 护理方法
常规护理方法：根据产科护理相关指南进行干预，并进行相关健康教育，按照新产程定义的标准及相关指南操作，注意及时处理不协调宫缩，教会产妇呼吸配合方法，进行全程监护，必要时选择剖宫产。
新模式护理方法：新模式护理组研究对象在接受常规护理服务的前提下，接受额外的护理服务。主要护理措施如下：术前做好心理护理，针对研究对象对于分娩的恐惧、焦虑不安等情绪，帮助其平稳心态;保持母亲与日常护理者的良好关系，可以减轻宫缩引起的疼痛，促进母亲产后恢复，使产妇在生活中更积极。从心理上讲，护理人员与母亲建立并保持良好的关系，通过沟通和鼓励，帮助初产妇减轻自然分娩的恐惧、悲观和焦虑。同时，护理工作人员为孕产妇讲解分娩过程和分娩呼吸指导，以及分娩注意事项，使孕产妇在分娩前充分做好心理准备;其次，在饮食方面，指导孕妇多吃高蛋白、高纤维的食物。指导孕产妇饮食更加多样化，增加其能量摄入;在行为方面，分娩前，在医生的指导下，适当地在舒适的位置运动，分娩后尽快下床。在第二产程注意为产妇进行适当的穴位按摩，注意主动护理、主动干预，提升产妇对于自然分娩的信心。
1.3 统计学方法
本研究中满意度等计數资料的比较分析运用χ2检验;平均年龄、时间和BMI平均值等计量资料的比较分析运用两独立样本t检验。检验水准设定为α=0.05。
2 结果
常规护理组58例研究对象中有53例自然分娩，5例剖宫产，剖宫产率为8.62%，其中自然分娩研究对象活跃期为（23.36 ±2.85）h，第一产程为（23.29 ±3.46）h，第二产程为（0.91±0.25）h，产时出血量为（211.07±13.46）ml;新模式护理组58例研究对象中有57例自然分娩，1例剖宫产，剖宫产率为1.72%，其中自然分娩研究对象活跃期为（21.58±3.14）h，第一产程为（19.98 ±2.76）h，第二产程为（0.79±0.55）h，产时出血量为（186.32±16.25）ml;新模式护理组中有56例研究对象对于护理服务“满意”，满意度为96.55%，常规护理组中有49例研究对象对于护理服务“满意”，满意度为84.48%，相比常规护理组，新模式护理组自然分娩的研究对象剖宫产率较低，活跃期、第一产程、第二产程时间均较短，产时出血量较少，满意度更高，差异均有统计学意义（P<0.05）。
3 讨论
给予孕产妇精细护理，是一种新兴的护理模式，它要求护士不仅要加强对孕产妇的关注，还要注意其心理、环境、身体因素等影响分娩结局的因素，是一种基于患者的社会、文化和身心需求的个性化护理方法。它包括对饮食、心理、行为等情况的指导和干预，有助于改善产妇的周围环境，减少甚至消除临产时的恐惧和焦虑[3]。本研究结果表明相比常规护理，对待产的孕妇实施新模式护理能更加显著的降低剖宫产率、缩短自然分娩过程中的活跃期、第一产程、第二产程的时间，并减少分娩时出血量，可予以推广。
参考文献：
[1] 剖宫产术后瘢痕子宫再次妊娠阴道分娩的临床分析[D]. 郑州大学， 2016.
[2] 刘馨. 分娩方式健康教育在孕产妇分娩过程中的影响[J]. 山西职工医学院学报， 2014（3）：59-60.
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论文作者:李静
论文发表刊物:《世界复合医学》2019年9期
论文发表时间:2020/1/16
标签：研究对象论文; 新模式论文; 自然论文; 常规论文; 满意度论文; 产妇论文; 活跃论文; 《世界复合医学》2019年9期论文;