孙丹　陈湘玉

[摘要] 目的 探討对剖宫产术实施快速康复护理的临床价值。 方法 选取2019年1～12月我院行计划性剖宫产术的孕产妇460例，随机分为对照组和观察组，每组各230例，对照组实施剖宫产围手术期常规护理，观察组在快速康复外科理念指导下开展针对性护理干预，具体操作为术前护理（健康教育、心理指导、缩短术前禁食禁饮时限）、术中护理（给予适量的麻醉剂量、采取保温措施、缩短剖宫产手术时间）、术后护理（饮食指导、体位管理、主动运动指导、心理护理、母乳喂养指导、疼痛管理）。比较两组临床效果及护理满意度。 结果 观察组护理满意度为99.13%，高于对照组的93.04%（P<0.05）;观察组手术前低血糖反应发生率为0.86%、术中低体温发生率为6.52%、不良反应发生率为2.61%、剖宫产手术时间为（55.47±5.33）min、母乳分泌时间为（19.23±4.37）h、排气时间为（20.58±3.37）h、下床活动时间为（38.82±6.54）h、产后48 h子宫底高度为（5.66±1.26）cm、住院时间为（4.65±1.48）d，全部低于对照组的3.91%、13.91%、11.30%、（61.78±6.04）min、（26.45±4.80）h、（29.35±4.28）h、（49.40±5.56）h、（7.25±1.40）cm、（5.70±1.50）d（P<0.05）。结论 针对行剖宫产术的孕产妇实施快速康复护理，有助于产妇术后尽快下床活动，并促进产妇快速康复，该护理方案值得应用并推广。

[关键词] 剖宫产术;快速康复护理;临床效果;孕产妇

[中图分类号] R248.3          [文献标识码] B          [文章编号] 1673-9701（2020）30-0168-04

Evaluation of the clinical effect of rapid rehabilitation nursing on cesarean section

SUN Dan1   CHEN Xiangyu2

1.School of Nursing， Nanjing University of Chinese Medicine， Nanjing   210023， China; 2.Affiliated Drum Tower Clinical Medical College of Integrated Chinese and Western Medicine of Nanjing University of Chinese Medicine， Nanjing 210008， China

[Abstract] Objective To explore the clinical value of rapid rehabilitation nursing for cesarean section. Methods A total of 460 pregnant women planning to undergo a cesarean section in our hospital from January to December 2019 were randomly divided into the control group（n=230） and the observation group（n=230）. The control group was treated with routine nursing during the perioperative period of cesarean section， while the observation group was treated with targeted nursing under the guidance of the concept of rapid rehabilitation surgery， including preoperative care（health education， psychological guidance， shortening the preoperative time limit for fasting and water deprivation）; intraoperative care（giving an appropriate dose of anesthesia， taking heat preservation measures， and shortening the time of cesarean section operation）; postoperative care（diet instructions， body position management， active exercise guidance， psychological care， breastfeeding instructions， pain management）. The clinical effect and nursing satisfaction of the two groups were compared. Results Nursing satisfaction in the observation group was 99.13% higher than 93.04% in the control group（P<0.05）. Preoperative hypoglycemic reaction was 0.86%， intraoperative hypothermia incidence was 6.52%， the incidence of adverse reactions was 2.61%， cesarean section time was（55.47±5.33） min， breast milk secretion time was（19.23±4.37） h， exhaust time was（20.58±3.37） h， out of bed activity time was（38.82±6.54） h， height of uterine fundus at 48 h after delivery was（5.66±1.26） cm， hospitalization time was（4.65±1.48） d， which were all lower in the observation group than 3.91%， 13.91%， 11.30%， （61.78±6.04） min， （26.45±4.80） h， （29.35±4.28） h， （49.40±5.56） h， （7.25±1.40） cm， （5.70±1.50） d， in the control group（P<0.05）. Conclusion The rapid rehabilitation nursing for women undergoing cesarean section is helpful for them to get out of bed as soon as possible after cesarean section and can promote their rapid recovery， which is worthy of application and promotion.

[Key words] Cesarean section; Rapid rehabilitation nursing; Clinical effect; Pregnant women

剖宫产是临床用于处理难产及其他高危妊娠的重要手段，能夠有效降低母婴的病死率，有效改善妊娠结局，近年来随着医学的发展，剖宫产手术的实施例数逐年上升[1]。但临床研究显示，由于该手术操作的特点，剖宫产也存在一定缺陷，此分娩方式对产妇身体的创伤大，产后恢复时间长，影响产妇各项生理功能，并且容易引发较多并发症，目前临床对剖宫产产妇的术后康复护理越发关注，实现剖宫产产妇术后快速恢复也是临床护理工作追求的目标，快速康复护理模式的应用为此提供了可能[2]。本研究对我院剖宫产产妇围术期采用快速康复护理干预，并将临床效果与常规护理比较，旨在探讨快速康复护理的应用效果与价值，现报道如下。……