陈雅 刘如珍 马信姬 刘钧方

[摘要] 目的 研究在产程中使用不同护理模式对糖尿病初产妇分娩质量的影响。方法 选取2019年1—8月在该院行阴道分娩的76例糖尿病初产妇，用数字随机表法分组。对照组（40例）产妇接受常规护理，观察组（36例）产妇接受一对一助产士陪产护理，对比干预效果。结果 观察组产妇的总产程时间更短，尤其第一产程时间显著低于对照组，观察组行产程监测中有效控制血糖的产妇比例显著高于对照组，且观察组产妇的产时出血量少于对照组;两组的新生儿窒息发生率及新生儿出生后0.5 h血糖值差异无统计学意义（P>0.05）。结论 糖尿病初产妇接受一对一助产士陪产护理可缩短产程，同时有利于产妇产程的血糖控制，减少产时出血，有益于母婴健康。

[关键词] 常规护理;一对一助产士陪产;糖尿病;初产妇;分娩质量

[中圖分类号] R47          [文献标识码] A          [文章编号] 1672-4062（2020）06（a）-0173-03

[Abstract] Objective To study the effect of using different nursing models on the delivery quality of diabetic primiparas during labor. Methods Seventy-six diabetic primiparas who had vaginal delivery in the hospital from January 2019 to August 2019 were selected and grouped by random table method. The women in the control group （40 cases） received routine nursing， and the women in the observation group （36 cases） received one-on-one midwife nursing care， and compared the intervention effects. Results The total labor time of the women in the observation group was shorter， especially the time of the first labor was significantly lower than that of the control group. In the control group; there was no statistically difference in the incidence of neonatal asphyxia and blood glucose in 0.5 hour after birth（P>0.05）. Conclusion Diabetic primiparas receiving one-on-one midwife attendant care can shorten the birth process， and at the same time， it is conducive to the blood sugar control of the birth process， reducing bleeding during delivery， and is beneficial to the health of mothers and infants.

[Key words] Routine care; One-on-one midwife attendance; Diabetic; Primipara; Delivery quality

糖尿病产妇的身体条件有别于健康产妇，糖尿病产妇分为2种情况，一种情况是妊娠期患有糖尿病的产妇，另一种情况是怀孕前已经患有糖尿病，但无论是哪种情况均加重了产妇生产时的风险。对于糖尿病产妇，临床上需要加强护理干预。常规护理是一种传统的护理方法，由产科护士对产妇进行常规产前护理，并辅助产妇完成分娩的过程[1-2]，但常规护理主要侧重于辅助产妇分娩，未对产妇进行针对性的饮食指导，与产妇产程中的血糖控制，不利于母婴健康。该院2019年1—8月期间进行一对一助产士陪产的护理服务，研究该模式最大程度上安抚产妇情绪，提高产妇在产程中的饮食管理，助产士对饮食的动态指导，同时提高产妇的依从性，使其积极配合完成分娩，也能够拉近护患之间的距离。现共……