高危妊娠管理加助產(chǎn)護(hù)理門(mén)診對(duì)瘢痕子宮孕婦分娩結(jié)局的影響

廖太秀　肖婷婷　梁會(huì)英　甘淑珍

【摘要】 目的：探究高危妊娠管理聯(lián)合助產(chǎn)護(hù)理門(mén)診對(duì)改善瘢痕子宮孕婦分娩結(jié)局的影響。方法：選取2014年1月-2017年5月在本院門(mén)診產(chǎn)檢的瘢痕子宮孕婦90例，根據(jù)孕婦的意愿將其分為對(duì)照組和觀察組，各45例。對(duì)照組接受常規(guī)高危妊娠管理以及分娩護(hù)理，觀察組接受高危妊娠管理、助產(chǎn)護(hù)理門(mén)診和分娩護(hù)理，對(duì)比兩組的分娩結(jié)局。結(jié)果：干預(yù)2個(gè)月、臨產(chǎn)前、分娩后，兩組的SAS、SDS評(píng)分較干預(yù)前均明顯降低，且觀察組均顯著低于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組孕婦的陰道分娩率為40.00%（18/45），高于對(duì)照組的11.11%（5/45），產(chǎn)后2 h出血量少于對(duì)照組，產(chǎn)后并發(fā)癥發(fā)生率低于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組新生兒出生1 min的Apgar評(píng)分顯著高于對(duì)照組，并發(fā)癥發(fā)生率低于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：對(duì)瘢痕子宮孕婦開(kāi)展高危妊娠管理和助產(chǎn)護(hù)理門(mén)診有助于孕婦在妊娠期做好自我護(hù)理保健，規(guī)避各種不利因素，保證胎兒的健康發(fā)育，改善分娩結(jié)局。

【關(guān)鍵詞】 高危妊娠管理； 助產(chǎn)護(hù)理門(mén)診； 瘢痕子宮孕婦； 分娩結(jié)局

The Effect of High Risk Pregnancy Management Combined with Midwifery Care Clinic on Delivery Outcome of Scar Uterine Pregnant Women/LIAO Tai-xiu，XIAO Ting-ting，LIANG Hui-ying，et al.//Medical Innovation of China，2017，14（30）：079-082

【Abstract】 Objective：To explore the effect of high-risk pregnancy management combined with midwifery nursing clinic for improving the outcome of delivery of pregnant women with scar.Method：From January 2014 to May 2017 in our hospital outpatient examination of the scar uterus pregnant women selected 90 cases，according to the wishes of pregnant women will be divided into the control group and the observation group，45 cases in each group.The control group received regular high-risk pregnancy management and childbirth care，the observation group received high-risk pregnancy management，midwifery care outpatient and childbirth care，the birth outcomes of the two groups were compared.Result：After 2 months，before delivery，after delivery，the SAS and SDS scores of the two groups were significantly lower than those before intervention，and the SAS score and SDS scores of the observation group were significantly lower than those in control group，the differences were statistically significant（P<0.05）.The rate of vaginal delivery was 40.00%（18/45） in the observation group，which higher than 11.11%（5/45） of the control group，2 hours postpartum hemorrhage in the observation group less than that in the control group，and the incidence of postpartum complications was lower than that of the control group，the differences were statistically significant（P<0.05）.The Apgar score of 1 min in the observation group was significantly higher than that in the control group，and the complication rate of the observation group，significantly lower than that of the control group，the differences were statistically significant（P<0.05）.Conclusion：High risk pregnancy management and midwifery nursing care for pregnant women with scarring can help pregnant women to do self-care during pregnancy，avoid various unfavorable factors，ensure healthy development of fetus and improve delivery outcome.endprint

【Key words】 High risk pregnancy management； Midwifery care clinic； Scar uterine pregnant women； Delivery outcome

First-authors address：Ganzhou Peoples Hospital，Ganzhou 341000，China

doi：10.3969/j.issn.1674-4985.2017.30.023

首次剖宮產(chǎn)會(huì)造成子宮瘢痕，而隨著剖宮產(chǎn)率的持續(xù)攀升和二胎政策的開(kāi)放，瘢痕子宮孕婦逐漸增多，其容易出現(xiàn)多種妊娠期和圍生期的并發(fā)癥，影響母兒生命健康[1-2]。作為一種高危妊娠，在孕期加強(qiáng)對(duì)患者的高危妊娠管理，及早規(guī)避妊娠期的各種危險(xiǎn)因素，能在一定程度上避免不良妊娠結(jié)局的發(fā)生[3-4]。為有效改善妊娠結(jié)局，本院在瘢痕子宮孕婦妊娠期加用助產(chǎn)護(hù)理門(mén)診，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料 于2014年1月-2017年5月在本院產(chǎn)科門(mén)診產(chǎn)檢的瘢痕子宮孕婦中選出90例，全部孕婦距離最近一次剖宮產(chǎn)時(shí)間超過(guò)2年，均為單胎妊娠，無(wú)子宮損傷史；排除合并其他高危因素的孕婦，根據(jù)孕婦的意愿分為為對(duì)照組和觀察組。對(duì)照組孕婦45例，年齡28～39歲，平均（32.2±2.6）歲；孕周14～23周，平均（18.21±2.33）周；本科及以上9例，大專(zhuān)16例，高中10例，初中及以下10例。……