冯美娟 苏艳桃 叶仕英

[摘要]目的 探讨基于医院为主导的延续护理服务在高龄产妇产后护理中的应用效果。方法 回顾性分析2016年10月～2018年4月我院产科住院的单胎自然分娩高龄产妇120例，根据延续护理服务方式不同分为观察组（n=56）和對照组（n=64）。观察组提供以医院为主的延续护理服务，对照组提供以社区为主的延续护理服务。比较两组产后并发症发生率及泌乳量情况、生活质量。结果 两组产后子宫复旧不良发生率比较，差异无统计学意义（P>0.05）;观察组的产后乳腺炎、产后便秘、会阴切口愈合不良、压力性尿失禁等并发症发生率及产后抑郁症阳性率明显低于对照组，泌乳量和产后生活质量评分明显高于对照组，差异均有统计学意义（P>0.05）。结论 对高龄产妇出院后实施基于医院为主导的延续护理服务能明显减少高龄产妇产后并发症及产后抑郁症的发生，提高高龄产妇的生活质量和新生儿母乳喂养率，应积极主动推广。

[关键词]延续护理;高龄产妇;产后;并发症

[中图分类号] R473.71          [文献标识码] A          [文章编号] 1674-4721（2019）7（a）-0206-04

[Abstract] Objective To explore the effect of hospital-led continuing nursing service on elderly pregnant women after delivery. Methods The clinical data of 120 elderly pregnant women with single birth and spontaneous delivery in obstetrics department of our hospital from October 2016 to April 2018 were retrospectively analyzed. The patients were divided into the observation group （n=56） and the control group （n=64） according to the different continuing nursing service. The observation group was provided hospital-based continuing nursing services and the control group was provided community-based continuing care services. The incidence of postpartum complications and milk yield and the quality of life were compared between the two groups. Results There was no significant difference in the incidence of uterine involution between the two groups （P>0.05）. The incidence of complications such as postpartum mastitis， postpartum constipation， poor perineal incision healing， stress urinary incontinence and the positive rate of postpartum depression in the observation group was significantly lower than that of the control group， milk production and postpartum quality of life scores were significantly higher than those of the control group， the differences were statistically significant （P<0.05）. Conclusion The implementation of hospital-based continuing nursing service for elderly pregnant women after discharge can significantly reduce the incidence of postpartum complications and postpartum depression， improve the quality of life and breast-feeding rate of newborns， which should be actively promoted.

[Key words] Continued nursing service; Elderly pregnant women; Postpartum; Complication

延续护理的实践模式包括两种，基于社区的延续性护理模式和基于医院的延续性护理模式;其中基于医院的延续性护理模式是指由医院提供或以医院为主协同社区开展的延续性护理模式[1]。随着“全面二孩”政策，这两年高龄产妇的比例急剧上升。高龄产妇存在新陈代谢变慢，在体力和精力上的恢复比年轻产妇都要慢的问题，对延续护理的服务要求就更高。目前我……