李凌虹 苏方方

[摘要] 目的 研究陰道分娩的产妇产后出血问题能否通过预见性护理得到有效的控制甚至避免，为临床的医护工作提供依据。方法 方便选择2017年1月—2018年1月该院收治的180例经阴道分娩产妇作为研究对象，严格筛选其阴道分娩的指征，按产妇的入院顺序随机分入对照组与实验组，每组90例。对照组产妇采取常规的产后护理方法，实验组产妇实施预见性护理干预措施。计算两组产妇的阴道分娩产后出血发生率；记录并计算两组出现产后出血的产妇，在产后2 h的平均出血量以及产后24 h的平均出血量。比较两组产妇的护理成效。结果 对照组产妇产后出血发生15例，发生率为16.7%；实验组产妇产后出血发生7例，发生率为7.8%；用χ2检验比较两组产后出血发生率，实验组明显低于对照组，差异有统计学意义（χ2=12.9，P<0.05）。对照组产妇产后2 h平均出血量为（146.5±28.1）mL；产后24 h平均出血量为（238.3±21.7）mL。实验组产后2 h平均出血量为（79.4±29.1）mL；产后24 h平均出血量为（154.7±28.4）mL。使用t检验比较两组产后2 h平均出血量和产后24 h平均出血量，差异有统计学意义（t2h=23.46，t24h=33.04，P<0.05）。 结论 阴道分娩产妇采用预见性护理能降低阴道分娩产后出血发生率，对于发生产后出血的产妇，具有明显减少产后出血量的作用，使产妇受益。

[关键词] 产后出血；预见性护理；效果

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）08（b）-0120-03

Nursing Analysis of Predictive Nursing on Reducing Postpartum Hemorrhage in Vaginal Delivery

LI Ling-hong， SU Fang-fang

Department of Obstetrics， Xiamen Maternal and Child Health Hospital， Xiamen， Fujian Province， 361000 China

[Abstract] Objective To study whether the postpartum hemorrhage of vaginal delivery can be effectively controlled or even avoided through predictive care and provide evidence for clinical care. Methods 180 cases of vaginal deliveries were convenient selected from January 2017 to January 2018 in the hospital as subjects. The indications for vaginal delivery were strictly screened and randomly assigned to the control group and the experimental group according to the maternal admission order， with 90 patients in each group. Maternal women in the control group used routine postpartum care， and the women in the experimental group performed predictive nursing interventions. The incidence of postpartum haemorrhage in the vaginal delivery of the two groups of maternal women was calculated； the maternal women who had postpartum haemorrhage were recorded and calculated. The average amount of bleeding at 2 hours postpartum and the average amount of bleeding at 24 hours postpartum were calculated. Compare the maternal care results of the two groups. Results The incidence of postpartum hemorrhage in the control group was 15 case. The incidence rate was 16.7%. The postpartum hemorrhage occurred in 7 cases in the experimental group with incidence rate was 7.8%. The incidence of postpartum hemorrhage was compared with the chi-square test. The experimental group was significantly lower than the control group， the difference was statistically significant （χ2=12.9，P<0.05）. The average blood loss 2 h after maternal birth in the control group was （146.5±28.1）mL； the average blood loss 24 h after delivery was （238.3±21.7）mL. The average blood loss 2 h postpartum in the experimental group was （79.4±29.1）mL； the average blood loss 24 h postpartum was （154.7±28.4）mL. The t-test was used to compare the average blood loss at 2 hours postpartum and the average postpartum hemorrhage at 24 hours post-natally， and the difference was statistically significant （t2h=23.46，t24 h=33.64P<0.05）. Conclusion Predictive care for vaginal deliveries can reduce the incidence of postpartum haemorrhage in vaginal delivery， and it can significantly reduce postpartum hemorrhage for maternal women with postpartum hemorrhage， benefiting the mother.

[Key words] Postpartum hemorrhage； Predictive care； Effect

阴道分娩产后出血主要是由于胎盘位置、子宫收缩不良，感染等。在临床工作中，阴道分娩产后出血常常会引发产妇惊慌、恐惧等不良情绪，也会引发医患矛盾；大量出血导致血容量迅速下降，引起失血性休克，危及患者生命[1]。因此，如何能更好地减少出血发生率，降低出血量，是临床工作中需要注意的問题[2]。在实践中发现，采取预见性护理干预可有效降低出血风险、减少出血量[3]。现为进一步明确，在该院开展了该次研究，产妇入组的日期为2017年1月—2018年1月，共纳入180例阴道分娩产妇，现报道如下。……