陈秋花 刘芬 龚春红

[摘要]目的 探討护理干预对硬膜外分娩镇痛中转剖宫产妊娠期高血压产妇的影响效果。方法 选择2013年2月～2017年2月我院行硬膜外分娩镇痛中转剖宫产妊娠期高血压产妇122例作为研究对象，依据病房号单偶数将产妇分为对照组和实验组，每组各61例。对照组产妇采用常规护理模式，实验组产妇采用护理干预的手段，比较分析两组产妇宫缩即刻（T0）、镇痛即刻（T1）、分娩镇痛30 min后（T2），、剖宫产中转前（T3）、麻醉即刻（T4）、切皮时（T5）以及手术结束（T6）各时段收缩压。结果 镇痛期间，实验组产妇T1、T2、T3时刻收缩压指标低于对照组，T2、T3时刻舒张压指标低于对照组，差异有统计学意义（P<0.05）；两组产妇T0时刻收缩压、T0和T1时刻舒张压比较，差异无统计学意义（P>0.05）。剖宫产手术期间，实验组患产妇T4、T5、T6时刻收缩压和舒张压均低于对照组，差异有统计学意义（P<0.05）。结论 对硬膜外分娩镇痛中转剖宫产妊娠期高血压产妇而言，护理干预手段的运用，可有效实现血压控制，改善临床症状，存在推广价值。

[关键词]护理干预；硬膜外分娩镇痛；剖宫产；妊娠期高血压

[中图分类号] R473.71 [文献标识码] A [文章编号] 1674-4721（2018）2（a）-0189-04

[Abstract]Objective To investigate the effect of nursing intervention on transfer of caesarean section for pregnancies with gestational hypertension undergoing epidural labor analgesia.Methods Altogether 122 cases of pregnancies with gestational hypertension who underwent epidural labor analgesia and were transferred for cesarean section from February 2013 to February 2017 were selected as the subjects of this research and divided according to the difference between the single and even number of wards into two groups，61 cases in each group.The control group was received routine nursing care；while，the experiment group was treated with nursing intervention.The systolic pressure at instant uterine contraction （T0），instant analgesia（T1），30 minutes after labor analgesia（T2），before transfer of cesarean section （T3），at instant anesthesia（T4），skin incision（T5） and the completion of the operation（T6） were compared between two groups.Results During analgesia，the systolic pressure indexes of the experiment group at T1，T2 and T3 were lower than those of the control group，the diastolic pressure indexes at T2 and T3 were lower than those of the control group，with statistically significant difference（P<0.05）；the systolic pressure at T0 and diastolic blood pressure at T0 and T1 of two groups had no statistically significant difference （P>0.05）.During the cesarean section，the systolic pressure and diastolic pressure at T4，T5 and T6 of the experiment group were lower than those of the control group，with statistically significant difference（P<0.05）.Conclusion Application of nursing intervention in pregnancies with gestational hypertension undergoing epidural labor analgesia for transfer of caesarean section can effectively control blood pressure and improve clinical symptoms，which is of great promotion value.

[Key words]Nursing intervention；Epidural labor analgesia；Cesarean section；Pregnancy induced hypertension

妊娠期高血压疾病是由妊娠、血压升高混合而成的疾病类型，发病率占5%～12%，涉及妊娠期高血壓、子痫前期和子痫、子痫前期慢性高血压、妊娠合并慢性高血压等表现[1]，若因治疗不及时或不彻底，则会对孕妇、新生儿生命安全产生威胁。而在目前医学领域，以护理干预为主导的妊娠期高血压护理工作，俨然成为主治医师、患者及社会关注的重点。为更好提升该部分产妇临床治疗效果，本文以行硬膜外分娩镇痛中转剖宫产妊娠期高血压产妇作为研究对象，探讨护理干预对硬膜外分娩镇痛中转剖宫产妊娠期高血压产妇的影响效果，现报道如下。……