导乐陪产联合综合护理干预对瘢痕子宫再妊娠孕妇分娩中的应用论文_杨敏

黑河市爱辉区妇幼保健院 黑龙江黑河市 164300

摘要:目的:探讨分析导乐陪产联合综合护理干预对瘢痕子宫再妊娠孕妇分娩在临床中的的应用。方法:将我院收治的2017年4月至2018年4月90例瘢痕子宫再妊娠孕妇作为研究样本,分为实验组和参考组,实验组45例,在常规护理基础上接受导乐陪产联合综合护理;参考组45例,接受常规护理,对比两组分娩情况及孕妇产程时间。结果:实验组的自然分娩成功率为80%,明显高于参考组的66.7%,手术分娩率20%明显低于对照组的33.3%,且总产程用时即第一、二、三产程用时之和均短于参考组,差异有统计学意义(P<0.05)。结论:导乐陪产联合综合护理干预对瘢痕子宫再妊娠孕妇分娩是有临床医学价值的,能有效提高自然分娩成功率,缩短产程用时,值得临床推广。

关键词:导乐陪产联合综合护理干预;瘢痕子宫;分娩

Application of comprehensive nursing intervention of guided music and accompanying nursing to the delivery of pregnant women with scar uterus and pregnancy

Objective:To investigate the clinical application of the comprehensive nursing intervention of guide music and accompanying labor in the delivery of pregnant women with scar uterus and re-pregnancy. Methods:90 cases of pregnant women with scar uterus re-pregnancy admitted to our hospital from April 2017 to April 2018 were used as research samples.They were divided into experimental group and reference group. The experimental group was 45 cases,based on routine nursing. Under the comprehensive care of the guided music accompanying group,the reference group of 45 patients received routine care,comparing the two groups of delivery and the maternal labor time. Results:The success rate of natural delivery in the experimental group was 80%,which was significantly higher than 66.7% in the reference group. The surgical delivery rate was 20% lower than that in the control group,and the total labor was only used in the first,second and third stages. The differences were statistically significant(P<0.05).Conclusion:The comprehensive nursing intervention of guided music and accompanying nursing has clinical value for the delivery of pregnant women with scar uterus and re-pregnancy. Le paternity can effectively alleviate all kinds of bad psychology of maternal women. It is worthy of clinical promotion.

Key words:guided music accompanied by comprehensive nursing intervention;scar uterus;childbirth

随着我国生育政策的改革,现阶段的瘢痕子宫再次妊娠率明显上升,但在瘢痕子宫再妊娠过程中,孕妇子宫壁变薄,结缔组织弹性降低,胎儿生长发育使得子宫逐渐变大[1],孕妇在妊娠晚期或分娩过程中易发生子宫破裂,引发大出血及新生儿窒息等严重后遗症。由此在妊娠过程中,对孕妇予以心理及产程护理确保母婴安全具有重要作用[2]。本研究选取90例子瘢痕子宫再妊娠孕妇,研究导乐陪产联合综合护理干预对其分娩成功率及产程时间的影响。

1资料与方法

1.1一般资料

选取2017年4月至2018/4年我院收治的90例瘢痕子宫再妊娠孕妇作为研究样本,孕妇年龄(21-40)岁,平均年龄为27岁,孕周(28-43)周,平均孕周为36.1周.孕妇中有一次剖宫产史的患者为54人,有子宫肌瘤剔除史9,距上次手术时间(1-12)年。实验对象的子宫瘢痕厚度为(0.23-0.86)cm,平均厚度0.36.按照随机数表法将90例患者分为实验组和参考组,实验组45例,在常规护理基础上接受导乐陪产联合综合护理,参考组45例,接受常规护理,对比两组分娩情况及孕妇产程时间。两组孕妇年龄,孕周方面比较差异无统计学意义(P<0.05),具有可比性。

1.2方法

对参考组进行常规护理,包括产前检查及注意事项指导等,实验组在常规护理基础上进行导乐陪产联合综合护理干预。具体包括产前对讲解瘢痕子宫再妊娠分娩相关知识及注意事项的讲解,在此过程中积极回复孕妇相关疑问,转移孕妇注意力,疏导产前焦虑情绪,提高其自然分娩信心。护理人员密切监测产妇生命体征,记录血压、宫缩、胎心等信息。在孕妇剧烈宫缩时,指导其采用正常呼吸节奏,减轻产妇压力。在分娩过程中,指导产妇采取正确用力方法配合分娩,强调自然分娩的重要性,及时告知胎儿情况。必要时可采用会阴切开术,以缩短产程用时。在第三产程后,检查子宫情况,并观察子宫收缩,记录产妇产后出血、尿量等情况,嘱咐产妇家属加强与产妇的沟通。

1.3观察指标

两组产妇自然分娩率及总产程用时(即第一、二、三产程用时之和)。

3讨论

自然分娩有对产妇损伤小,利于产后恢复,有助于产后初乳分泌,分娩镇痛过程还可促进宫内恶露外排,利于子宫复原等益处[3]。但瘢痕子宫再妊娠产妇分娩多被迫中转剖宫产情况,在产妇分娩过程中进行导乐陪产联合综合护理干预具有重要作用。由此可见,积极与产妇沟通,可缓解其疼痛,指导患者在分娩过程中正确施力,缩短产程,亲属的积极沟通可减少产妇产后失落情绪,预防产后抑郁,加快建立母婴感情。

综上所述,导乐陪产联合综合护理干预应用于瘢痕子宫再妊娠孕妇,可提高自然分娩成功率,并缩短产程用时,可广泛应用于临床。

参考文献:

[1]杨金娥.剖宫产术后瘢痕子宫再次妊娠经阴道分娩的可行性及安全性研究[J].中国当代医药,2017,24(16):107-110.

[2]聂芹.瘢痕子宫再次足月妊娠分娩应用综合护理干预的临床研究[J].实用临床医药杂志,2017,21(4):135-137.

[3]刘亚辉,董秀英,杨秋英,等.综合护理干预对瘢痕子宫再次足月妊娠分娩结局的影响[J].河北医学,2015,21(11):1897-1900.

论文作者:杨敏

论文发表刊物:《健康世界》2018年24期

论文发表时间:2018/12/21

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导乐陪产联合综合护理干预对瘢痕子宫再妊娠孕妇分娩中的应用论文_杨敏
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