李洁盈　刘月改　李小赏

[摘要] 目的 探討优质服务在初产妇前置胎盘剖宫产术后出血中的干预效果。 方法 选取2014年1月～2016年1月在河北省衡水市第二人民医院分娩的86例前置胎盘初产妇作为研究对象，按照随机数字表法将其分为实验组和对照组，实验组43例患者，分娩过程中给予优质服务；对照组43例患者，分娩过程中给予常规护理措施；观察比较两组产妇的产后出血率、24 h出血量、产妇对护理工作的满意度以及两组产妇护理前后的焦虑和抑郁评估情况等。 结果 实验组有1例产妇出现产后出血，发生率为2.3%；对照组有4例产妇出现产后出血，发生率为9.3%；两组产妇产后出血率比较差异有统计学意义（P < 0.05）。实验组产妇产后24 h出血量为（123±82）mL；对照组产妇产后24 h出血量为（295±86）mL；两组产妇产后24 h出血量比较，差异有统计学意义（P < 0.05）。实验组产妇对护理工作的满意度为95.3%，高于对照组的81.4%，差异有统计学意义（P < 0.05）。两组产妇护理前的焦虑和抑郁评分比较，差异无统计学意义（P > 0.05）；护理后的焦虑和抑郁评分比较，差异有统计学意义（P < 0.05）；护理前后焦虑和抑郁评分两组产妇组内比较，差异有统计学意义（P < 0.05）。 结论 优质服务在初产妇前置胎盘剖宫产术后出血中的应用效果显著，可有效降低产后出血率，减少出血量，提高产妇满意度，缓解其产后心理状态，具有一定的临床应用价值。

[关键词] 优质服务；初产妇；前置胎盘；剖宫产

[中图分类号] R473.71 [文献标识码] A [文章编号] 1673-7210（2016）12（a）-0170-04

Effect of high quality service in the hemorrhage after cesarean section with placenta of the first woman

LI Jieying LIU Yuegai LI Xiaoshang

Department of Obstetrics and Gynecology， the Second People's Hospital of Hengshui City， Hebei Province， Hengshui 053000， China

[Abstract] Objective To explore the effect of high quality service in the hemorrhage after cesarean section with placenta of the first woman. Methods 86 cases of maternal placenta in the Second People's Hospital of Hengshui City in Hebei Province from January 2014 to January 2016 were selected as the research objects. They were divided into experimental group and control group according to the random number table method. In the experimental group， 43 patients were given high quality service during delivery. In the control group， 43 cases were given routine nursing measures during delivery. The maternal postpartum hemorrhage rate， 24 h bleeding， maternal satisfaction with the nursing work and the maternal care before and after the anxiety and depression assessment of the two groups were observed and compared. Results In the experimental group， there was 1 case of postpartum hemorrhage， the incidence rate was 2.3%； in the control group， there were 4 cases of postpartum hemorrhage， the incidence rate was 9.3%； there was significant difference in postpartum hemorrhage rate between the two groups （P < 0.05）. In the experimental group， the amount of postpartum hemorrhage of 24 h was （123±82） mL， in the control group， the amount of postpartum hemorrhage of 24 h was （295±86） mL， the maternal postpartum hemorrhage of 24 h of two groups was compared， the difference was statistically significant （P < 0.05）. The satisfaction of nursing work in the experimental group was 95.3%， higher than that of the control group （81.4%）， the difference was statistically significant （P < 0.05）. There was no significant difference in anxiety and depression scores between the two groups before nursing （P > 0.05）， there was significant difference in the scores of anxiety and depression after nursing （P < 0.05）， the scores of anxiety and depression before and after nursing were compared between the two groups， the differences were statistically significant （P < 0.05）. Conclusion High quality service significantly in early maternal placenta previa hemorrhage after cesarean section in the application effect， can effectively reduce the rate of postpartum hemorrhage， reduce blood loss， improve maternal satisfaction， alleviate postpartum mental state， it has certain clinical application value.

[Key words] High quality service； Primipara； Placenta praevia； Cesarean section

前置胎盘是指在妊娠28周后胎盘位置异常，一般附着在子宫下段，下缘接近子宫颈口，位置低于胎儿先露[1]。胎盘前置是女性妊娠期比较严重的并发症，也是妊娠晚期出血及产后出血的主要原因，如果针对出现前置胎盘的现象不能及时正确处理，会危及产妇和新生儿的生命安全。胎盘在胎儿的生长发育过程中起十分重要的作用，是胎儿的附属物，正常情况下附着于子宫体部的后壁、前壁或侧壁，如果位置异常会对母体和新生儿造成危害。前置胎盘的致病因素目前尚不清楚，一般与多次妊娠、多次人工流产、多次刮宫操作及剖宫产手术等有关[2-3]。……