兰小曼 兰鹰 覃桂莲

[摘要] 目的 观察集束化护理在产后腹直肌分离患者康复治疗中的应用效果。 方法 选取2017年2月～2019年7月广西科技大学第一附属医院产科门诊收治的60例产后腹直肌分离患者为研究对象，采用随机数字表法分为对照组和观察组，每组30例。对照组应用神经肌肉电刺激联合雷火灸治疗，随后采用常规护理，观察组在对照组基础上应用集束化护理干预。观察两组治疗前后腹直肌分离距离、腰背疼痛改善情况及患者满意度情况。 结果 两组治疗前脐上腹直肌分离和脐下腹直肌分离距离比较，差异无统计学意义（P > 0.05）。两组治疗后脐上腹直肌分离和脐下腹直肌分离距离短于治疗前，且观察组短于对照组，差异均有统计学意义（均P < 0.05）。兩组治疗前腰背疼痛情况比较，差异无统计学意义（P > 0.05）;两组治疗后腰背疼痛人数少于治疗前，且观察组少于对照组，差异均有统计学意义（均P < 0.05）。观察组满意度高于对照组，差异有统计学意义（P < 0.05）。 结论 集束化护理干预能有效提高产后腹直肌分离患者的康复效果和满意度，具有较高临床应用价值。

[关键词] 集束化护理;腹直肌分离;产后;神经肌肉电刺激;雷火灸

[中图分类号] R71          [文献标识码] A          [文章编号] 1673-7210（2020）07（a）-0175-04

[Abstract] Objective To observe the effect of cluster nursing in rehabilitation treatment of postpartum patients with diastasis recti abdominis. Methods From February 2017 to July 2019， 60 cases with diastasis recti abdominis who treated in the First Affiliated Hospital of Guangxi University of Science and Technology were selected as the objects. They were divided into the control group and the observation group by the random number table method， with 30 cases in each group. The patients in the control group were received routine nursing after the treatment of neuromuscular electrical stimulation combined with thunder-fire moxibustion. The observation group were received cluster nursing intervention on the basis of the control group. The distance of diastasis recti abdominis， the improvement of low back pain and patient satisfaction were observed before and after treatment. Results Before treatment， there was no statistically significant difference between the two groups in the distance of diastasis recti abdominis （P > 0.05）. After treatment， the distance of diastasis recti abdominis between the two groups were shorter than those before treatment， and the observation group was shorter than the control group， with statistically significant differences （all P < 0.05）. There was no significant difference in the improvement of low back pain between the two groups （P > 0.05）. The number of the improvement of low back pain patients in the two groups were less than those before treatment， and the observation group was less than the control group， with statistically significant differences （all P < 0.05）. The satisfaction rate of patients in the observation group was higher than that in the control group， and the difference was statistically significant（P < 0.05）. Conclusion Cluster nursing intervention can effectively improve the rehabilitation effect and satisfaction of patients with postpartum rectus abdominis separation， and has higher clinical application value.

[Key words] Cluster nursing; Diastasis recti abdominis; Postpartum; Neuromuscular electrical stimulation; Thunder-fire moxibustion

腹直肌分离症是指腹部两侧腹直肌从腹白线处分开，分离距离>2 cm。据报道，产后6周腹直肌分离发病率高达50%～60%[1]，部分患者产后6个月内会自行恢复，但如果腹直肌分离距离过大时难以自行恢复。腹直肌分离会导致腹部形体改变、腰部疼痛，甚至造成脏器移位和疝气等[2-3]。集束化护理是一系列有循证基础的相互关联的干预措施组合在一起形成的护理方案[4]。本研究将集束化护理应用于产后腹直肌分离患者，取得满意效果，现报道如下：