葛桂兰

[摘要] 目的 探讨综合护理干预对产妇分娩方式及产后出血的影响。方法 分析我院2014年10月～2015年10月收治的150例产妇的临床资料，依据护理干预不同进行分组，对照组50例和观察组100例。对照组给予常规的责任制护理模式，观察组给予综合护理干预。观察两组产妇护理干预前后地焦虑、抑郁心理评分，分娩方式、产程时间，产后2、24 h出血量。结果 两组产妇护理干预前的焦虑、抑郁心理评分差异均无统计学意义（P>0.05），干預后，两组产妇的焦虑、抑郁心理评分均低于干预前，观察组产妇干预后的焦虑、抑郁心理评分均低于对照组，自然分娩率高于对照组，剖宫产、阴道助产率均低于对照组，第一产程、第二产程、第三产程时间均短于对照组，产后2、24 h出血量均少于对照组，差异有统计学意义（P<0.05）。结论 综合护理干预应用于产妇可提高自然分娩率，改善其不良心理情绪，缩短产程，减少产后出血量，值得临床推广应用。

[关键词]综合护理干预；产妇；焦虑；抑郁；分娩方式；产程；产后出血

[中图分类号] R473.71 [文献标识码] A [文章编号] 1674-4721（2017）08（a）-0188-03

[Abstract]Objective To discuss the influence of comprehensive nursing intervention on delivery mode and postpartum hemorrhage for puerpera.Methods Clinical data of 150 puerperae treated in our hospital from October 2014 to October 2015 were analyzed and they were divided into control group （50 cases） and observation group （100 cases） according to different nursing intervention.The control group was given routine nursing care mode，and the observation group was given comprehensive nursing intervention.The anxiety and depression psychology score，the delivery mode，the time of delivery and the 2 h and 24 h blood loss of puerperae in two groups were observed before and after the nursing intervention.Results The anxiety and depression psychology score between the two groups before nursing intervention were not statistically significant （P>0.05），after intervention，anxiety and depression psychology score of the two groups were lower than those before intervention，anxiety and depression psychology score in puerperae of the observation group were lower than those of the control group，the rate of natural childbirth was higher than that of the control group，the rate of cesarean section and vaginal delivery were lower than those of the control group，the first stage of labor，the second stage of labor，the third labor time were shorter than those of the control group，2 h and 24 h postpartum hemorrhage volume was less than those of the control group，the difference was statistically significant （P<0.05）.Conclusion Comprehensive nursing intervention applied in puerperae can improve the rate of natural childbirth，improve the adverse mental and emotional state，shorten the labor process and reduce the amount of postpartum hemorrhage.It is worthy of clinical promotion and application.

[Key words]Comprehensive nursing intervention；Puerpera；Anxiety；Depression；Delivery mode；Labor stages；Postpartum hemorrhage

近年来，随着医疗服务技术的不断进步和发展，一些产妇和家属对于正常分娩的认知水平不足，可能造成无医学指征剖宫产比例明显增高[1-2]。剖宫产的初衷是为了解决一些产妇难产、某些产科并发症，为了有效地运用剖宫产，提高产妇和家属对于分娩方式的认知水平，降低产后出血发生率[3-4]。有效的护理干预不仅关系到剖宫产产妇护理工作质量，同时也关系到产妇分娩方式和产后出血情况。综合护理干预主要从产妇心理、生命体征、分娩前特点、饮食等多个角度出发，给予综合性的护理干预。本研……