周子真

[摘要]目的 探讨个性化护理在前置胎盘患者中的应用效果。方法 选取2015年12月～2017年12月我院收治的40例前置胎盘患者作为研究对象，采用随机数字表法将其分为对照组、观察组，每组 20例。对照组产妇使用常规护理，观察组在对照组基础上施行个性化护理，比较两组产妇产期阴和出血、胎盘置入和产褥感染三项不良反应的发生率、患者满意率情况、护理前后心理状态和母婴结局。结果 对照组患者的不良反应发生率高于观察组，差异有统计学意义（P<0.05）；观察组满意率高于对照组，差异有统计学意义（P<0.05）。两组患者护理前的SAS评分和SDS评分比较，差异无统计学意义（P>0.05）；两组护理后SAS、SDS 均低于护理前且观察组护理后SAS、SDS均低于对照组，差异均有统计学意义（P<0.05）。观察组新生儿新生儿健康情况明显优于对照组的，差异有统计学意义（P<0.05）。结论 前置胎盘病人护理时，施行个性化护理可有效降低產妇不良反应的发生率，减轻产妇焦虑、抑郁等不良情绪；同时有利于新生儿的健康，可以被推广应用。

[关键词]前置胎盘；个性化护理；焦虑；抑郁

[中图分类号] R473.71 [文献标识码] A [文章编号] 1674-4721（2018）7（c）-0180-03

[Abstract] Objective To explore the effect of personalized nursing in patients with placenta previa. Methods Forty patients with placenta previa admitted to our hospital from December 2015 to December 2017 were selected as the research objects， and randomly divided into control group and observation group， with 20 cases in each group. The control group was given routine nursing， while the observation group was given individualized nursing on the basis of the control group. The incidence of vaginal bleeding， placenta accreta and puerperal infection， patients′ satisfaction， psychological state before and after nursing and maternal and infant outcomes were compared between the two groups. Results The incidence of adverse reactions in the control group was higher than that in the observation group， the difference was statistically significant （P<0.05）. The satisfaction rate of the observation group was higher than that of the control group （P<0.05）. There was no significant difference in SAS score and SDS score between the two groups before nursing （P>0.05）. SAS and SDS in the observation groups were lower than those in the control group， the differences were statistically significant （P<0.05）. The neonatal health status in the observation group was significantly better than that in the control group，the difference was statistically significant （P<0.05）. Conclusion For patients with placenta previa， application of personalized nursing can effectively reduce the incidence of adverse reactions in puerperae and relieve undesirable emotion such as maternal anxiety and depression. Meanwhile， it is beneficial to the health of newborns and can be promoted.

[Key words] Placenta previa； Personalized nursing； Anxiety； Depression

前置胎盘属于产妇妊娠期间常见的严重并发症之一。明显症状为产妇妊娠28周后出现胎盘异常下移，极易导致产妇出现休克、大出血等状况，大量出血时产妇可有贫血貌、脉搏微弱增快、血压下降等出血性休克表现[1-4]；也会使胎儿出现呼吸窘迫，危险性较大，对产妇及其胎儿的健康和生命安全造成严重的影响。临床进行B型超声断层显像可清楚看到子宫壁、胎先露部、胎盘和宫颈的位置，并根据胎盘边缘与宫颈内口的关系进一步明确前置胎盘的类型。为有效治疗，产妇应绝对卧床休息，纠正贫血并使用抗生素预防感染。如果孕龄<34周，抑制宫缩并给予促胎肺成熟[5-7]。同时严密观察病情并进行相关辅助检查。如反复大量出血、需酌情终止妊娠[8]。……