叶文　方晓红　熊文栋　王连云　王剑平　童夏　王繁

[關键词] 妊娠期高血压;子痫前期;正念干预;高危孕妇

[中图分类号] R714.24          [文献标识码] B          [文章编号] 1673-9701（2021）17-0060-05

Effect of mindfulness intervention on blood pressure of high-risk pregnant women during pregnancy and prevention of preeclampsia

YE Wen   FANG Xiaohong   XIONG Wendong   WANG Lianyun   WANG Jianping   TONG Xia   WANG Fan

Department of Obstetrics， the Second Affiliated Hospital of Wenzhou Medical University， Wenzhou   325000， China

[Abstract] Objective To study the effect of mindfulness intervention （mindfulness body scanning） on blood pressure of high-risk pregnant women during pregnancy， and to explore its feasibility in preventing preeclampsia. Methods Eligible pregnant women with high risk of gestational hypertension in the Department of Obstetrics of the Second Affiliated Hospital of Wenzhou Medical University from June 2018 to June 2019 were included as the research objects. They were randomly divided into two groups. The experimental group（n=27） underwent mindful body scanning at the specified time， while the control group （n=39） received no intervention measures. Both groups underwent normal prenatal examination. Finally，the maternal and infant outcomes of the two groups of high-risk pregnant women were analyzed. Results After adjusting SBP，DBP before intervention in both groups， after intervention，the SBP，DBP decreased in the experimental group effectively（95%CI： 6.797-12.276 mg， P<0.05; 95%CI： 3.070-6.963 mmHg， P<0.05）. The incidence of hypertensive disorder complicating pregnancy in the experimental group was 11.1%， which was slightly higher than that of（10.3%） in the control group， but without significant difference（P>0.05）. The incidence of preeclampsia was 0.0% in the experimental group， which was significantly lower than that of（20.5%） in the control group， with statistically significant difference（P<0.05）. The gestational weeks were （38.8±1.10）weeks in the experimental group， which was longer than that of （37.8±2.17） weeks in the control group， with statistically significant difference（P<0.05）. Conclusion Systematic mindful body scanning can reduce the pregnancy blood pressure of high-risk pregnant women and have a certain preventive effect on the occurrence of preeclampsia. Mindful body scanning has no economic pressure， with high safety and effectiveness，which can be used as one of the effective measures to prevent preeclampsia.

[Key words] Hypertensive disorder complicating pregnancy; Preeclampsia; Mindfulness intervention; High-risk pregnant women

妊娠期高血压疾病是一种妊娠期特有的疾病，包括妊娠合并慢性高血压、妊娠期高血压、子痫前期等，我国发病率为9.4%，严重影响母婴健康，是孕产妇和围生儿发病和死亡的主要原因之一。目前除终止妊娠外，该病尚无有效的治疗方式，因此如何预防成为了是目前研究的热点。学者们对阿司匹林预防子痫前期进行大量研究[1-2]，认为阿司匹林可以预防早发型子痫前期，但对晚发型子痫前期无明显影响。但是，有研究证实[3]阿司匹林可能会轻微增加超过500 mL的产后出血的风险，这一结果的证据质量被降级为中等。国际上补充与替代疗法正逐渐成为一种流行趋势，常常用于治疗各种健康问题，如心血管疾病、癌肿瘤等慢性疾病[4-6]，其中身心疗法在不同医学领域不断被证实有效[7]。正念觉知干预[8]作为一种安全和无介入的非药物治疗方式，也是在减轻压力、改善抑郁[9]、降低血压[10]等多个方面的评估中表现出临床上有显著意义的效果。纵观国内外的相关研究，有关正念练习与妊娠期高血压疾病的临床研究非常少，因此，通过病例对照研究，探讨正念练习的核心之一正念身体扫描对妊娠血压的影响及预防子痫前期的可行性，现报道如下。

1对象与方法

1.1研究对象

本研究于2018年6月至2019年6月在温州医科大学附属第二医院产科门诊孕妇中筛选具有妊娠高血压疾病高危因素的孕妇开展正念干预的随机分组试验。……