孙超等

[摘要] 目的 探讨舒适护理对剖宫产产妇术后应激反应及疼痛的影响。 方法 选取2013年1月～2014年1月我院拟行剖宫产术的足月初产妇80例，全部入选对象采用随机数字表分为干预组和对照组，干预组采取舒适护理，对照组采取常规护理，比较两组术后SAS评分、VAS评分、CORT水平及术后恢复情况。 结果 干预组术后第3天SAS评分较对照组降低更显著，干预组剖宫产术后肛门恢复排气时间、下床活动时间、泌乳时间较对照组显著缩短， 差异具有统计学意义（P<0.05）。干预组产妇术后24 h VAS评分较术前1 h及对照组均显著降低，差异具有统计学意义（P<0.05）。干预组产妇术后24 h CORT水平较术前1 h及对照组均显著降低，差异具有统计学意义（P<0.01）。 结论 对剖宫产产妇实施舒适护理干预，有利于降低患者术后的应激反应，促进产妇的术后恢复，减轻产后疼痛，从而提高患者的舒适度。

[关键词] 剖宫产；舒适护理；应激反应；疼痛

[中图分类号] R473.71 [文献标识码] B [文章编号] 1673-9701（2015）09-0143-04

Effect of comfortable nursing care on stress response and pain after cesarean section

SUN Chao1 FENG Suwen2

1.Delivery Room， Maternal and Child health Hospital of Zhoushan City in Zhejiang Province， Zhoushan 316000， China； 2.Department of Obstetrics， the Affiliated Obstetrics and Gynecology Hospital of Zhejiang University Medical College， Hangzhou 310006， China

[Abstract] Objective To explore the effect of comfort care on stress response and pain after cesarean section. Methods From January 2013 to January 2014 in my courtyard undergoing cesarean full-term primipara 80 cases were selected as objects，they were divided into intervention group and control group by random number table， intervention group was treated with comfort nursing care， the control group was treated with routine nursing care， two groups of postoperative SAS score， VAS score， CORT level and recovery were compared. Results The intervention group after operate at third day of SAS score decreased more significantly than the control group， with significant difference （P<0.05）， the intervention group cesarean section postoperative anal exhaust time， ambulation time， lactation time significantly were shorter than the control group （P<0.05）. The intervention group of women after 24 h VAS score compared with the preoperative 1 h and control group were significantly decreased， with significant difference （P<0.05）. The intervention group of women after 24 h the levels of CORT 1 h significantly decreased than the control group， with significant difference （P<0.01）. Conclusion The cesarean section to implement comfortable nursing intervention， helps to reduce the stress response in patients after operation， promoting maternal postoperative recovery， reduce postpartum pain， so as to improve the comfort of patients.

[Key words] Cesarean section； Comfort care； Stress reaction； Pain

随着医学模式的转变及现代护理学观念的不断更新，对护理工作提出了更高的要求，要求护理工作必须满足患者的护理需求，真正做到贴近患者、贴近临床、贴近社会。舒适护理（comfort care，CC）是一种全面整体的护理模式，主要是使患者的生理、心理达到理想的状态，更加关注患者的感受，强调要以爱心来对待每一位患者，从而促进患者的康复[1]。剖宫产手术是挽救母儿生命、解决难产的有效措施[2]。剖宫产产妇尤其是初产妇，易产生紧张、焦虑、恐惧等负性心理，加上手术应激，容易使产妇围术期心率加快、血压升高，从而影响母婴安全[3]。

1 资料与方法

1.1 一般资料

选取2013年1月～2014年1月我院拟行剖宫产术的足月初产妇80例，排除术前应用对血压、心率有影响药物的患者及患有精神系统疾病患者，所有患者均能够正确表达主观感受。年龄19～43岁，孕周均为足月，孕周37～40周。……