王利纯　廖丹　杨柳

[摘要] 目的 探討综合性护理对瘢痕妊娠产妇剖宫术后早期恢复及并发症发生的影响。 方法 选取我院2017年5月～2017年12月收治的瘢痕妊娠产妇75例，所有产妇随机分为观察组38例及对照组37例，对照组给予产前传统护理模式，观察组进行综合性护理。观察两组患者恢复情况、接受剖宫术后初乳时间、24 h哺乳次数、血清分泌素水平。护理满意度评价及患者并发症发生情况。 结果 观察组患者的肛门排气、下床活动、平均住院时间、平均阴道出血量及血液中β-HCG 水平恢复正常时间均低于对照组；观察组产妇的初乳时间短于对照组，24 h哺乳次数及血清分泌素水平均高于对照组；观察组的护理满意率明显高于对照组；产妇产后并发症发生率明显低于对照组，两组比较，差异均有统计学意义（P<0.05）。 结论 综合性护理可以促进瘢痕妊娠产妇剖宫术后早期恢复，减少并发症的发生，值得临床推广应用。

[关键词] 综合性护理；瘢痕妊娠；剖宫术；早期恢复；并发症

[中图分类号] R473.71 [文献标识码] B [文章编号] 1673-9701（2018）20-0155-03

Effect of comprehensive nursing on early recovery and complications after caesarean operation in puerperas with scar pregnancy

WANG Lichun LIAO Dan YANG Liu SUN Guiman

Department of Obstetrics，Hu'nan Provincial People's Hospital，Changsha 410002， China

[Abstract] Objective To investigate the effect of comprehensive nursing on the early recovery and complications after caesarean operation in puerperas with scar pregnancy. Methods 75 puerperas with scar pregnancy were selected from May 2017 to December 2017 in our hospital. All the puerperas were randomly divided into observation group（n=38）and control group（n=37）. The control group was given prenatal traditional nursing mode， and the observation group was treated with comprehensive nursing. The recovery of the two groups of patients， receiving colostrum time after cesarean section in the two groups， the number of breast-feeding within 24 h， serum secretin level， satisfaction evaluation of nursing and occurrence of complications were observed. Results The anal exhaust， ambulation， mean length of hospital stay， mean vaginal bleeding and recovery time of blood β-HCG levels in the observation group were lower than those in the control group. The colostrum time in the observation group was shorter than that in the control group. The number of breast-feeding within 24 hours and serum secretin level was higher than that of the control group. The satisfaction rate of nursing in the observation group was significantly higher than that of the control group. The incidence of postpartum complications was significantly lower in the observation group than that in the control group， and there was a statistically significant difference between the two groups（P<0.05）. Conclusion Comprehensive nursing can promote the early recovery of scar pregnant women after caesarean operation and reduce the occurrence of complications， which is worthy of clinical application.

[Key words] Comprehensive care； Scar pregnancy； Caesarean operation； Early recovery； Complications

瘢痕子宫多指患者的子宫因手术等因素导致切口处形成瘢痕的现象，多由子宫肌瘤术、剖宫产等引起。会对妊娠和分娩产生影响，难产、子宫破裂及产后出血的风险明显增加[1]，剖宫产率显著增高。如何加强对此类产妇的护理，使其顺利的完成分娩，已成为产科护理的重要课题[2]。近年调查发现，受初产妇产前心理因素影响，剖宫产术的发生率呈逐年上升趋势。国际卫生组织已经提出剖宫产率应控制在15%[3-5]。本研究采取综合性护理对瘢痕妊娠产妇剖宫术后早期恢复及并发症发生的影响进行分析，现报道如下。……