摘要
目的助产士引导的全程心理干预对初产妇的临床影响。方法回顾性分析2016年7月～2018年6月徐州市贾汪区人民医院收治分娩的初产妇168例,根据是否由助产士陪护分为观察组(90例)和对照组(78例)。对照组产妇给予常规助产、护理模式。观察组给予助产士引导的全程心理干预对初产妇。观察产妇分娩的产程时间、妊娠结局与新生儿结局。妊娠结局包括剖宫产、自然分娩、胎吸。新生儿结局包括新生儿体重及出生后5分钟Apgar评分。应用焦虑自评量表(SAS)、抑郁自评量表(SDS)于入院时与分娩后24h对患者情绪状态进行评估。观察两组产后并发症发生情况,主要包括宫缩乏力、产后出血、产褥感染、盆腔粘连等。结果与对照组比较,观察者总产程明显缩短,自然分娩率明显升高,剖宫产率及钳产率明显降低,新生儿出生后5分钟Apgar评分明显升高,差异有统计学意义(P <0.05)。观察组新生儿体重较对照组有所升高,但差异无统计学意义(P> 0.05)。两组入院时SAS评分和SDS评分比较,差异无统计学差异(P> 0.05)。分娩后观察组SAS评分与SDS评分明显低于对照组,差异有统计学意义(P <0.05)。观察组并发症发生率明显低于对照组,差异有统计学意义(17.95%vs 6.66%,χ士引导的全程心理干预可明显改善初产妇焦虑、抑郁心理,提高自然分娩率,缩短产程,有利于新生儿结局,降低产妇产后宫缩乏力、产后出血、产褥感染、盆腔粘连并发症发生率。
Objective To study the clinical effect of midwife-guided whole-course psychological intervention on primipara. Methods 168 cases of primipara were retrospectively analyzed and divided into observation group(n=90)and control group(n=78),who were in delivery room of the people’s hospital of Jiawang District of Xuzhou from July2016 to June 2018.The control group was given routine midwifery and nursing.The observation group was guided by midwives during the whole process of psychological intervention.The total stages of labor,pregnancy outcome(included cesarean section,natural delivery and forceps delivery) and neonatal outcome(included neonatal weight and Apgar score 5 minutes after birth) were observed.At admission and 24 hours after delivery,patients’ emotional state were assessed by self-rating anxiety scale(SAS) and self-rating depression scale(SDS).Postpartum complications were observed, including uterine inertia,postpartum hemorrhage,puerperal infection and pelvic adhesion. Results The total stages of labor,cesarean section rate and forceps rate in the observation group were significantly lower than those in the control group,while the natural delivery rate and Apgar score in 5 minutes after birth were significantly higher than those in the control group(P < 0.05).The weight of newborns in the observation group was higher than that in the control group,but there was no significant difference(P > 0.05).The weight of newborns in the observation group was higher than that in the control group,but there was no significant difference(P > 0.05).There was no significant difference in SAS score and SDS score between the two groups at admission(P > 0.05).The SAS and SDS scores in the observation group were significantly lower than those in the control group(P < 0.05).The incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(17.95% vs 6.66%,2=9.631,P=0.002). Conclusion Midwife-guided whole-course psychological intervention can significantly improve the anxiety and depression of primipara,increase the natural delivery rate,shorten the total stages of labor,conducive to neonatal outcomes,reduce the incidence of postpartum uterine inertia, postpartum hemorrhage,puerperal infection,pelvic adhesion complications.
作者
李艳侠
LI Yanxia(Delivery Room,the People's Hospital of Jiawang District of Xuzhou,Xuzhou 221011,China)
出处
《中国医药科学》
2018年第24期86-88,共3页
China Medicine And Pharmacy
关键词
助产士
分娩疼痛
产次
自然分娩
妊娠结局
Nurse Midwives
Labor Pain
Parity
Natural Childbirth
Pregnancy Outcome
