摘要
目的 探讨基于根因分析法的预见性护理干预对经阴道分娩产妇产后出血情况、舒适度的影响。方法 选取2022年6月—2023年4月医院收治的120例经阴道分娩产妇作为研究对象,按照组间资料均衡可比的原则将其分对照组和观察组,各60例。对照组接受常规护理,观察组接受基于根因分析法的预见性护理干预,比较两组产妇产后出血状况和出血相关指标[产后出血率、产后2 h和24 h出血量、血小板反应蛋白1(thrombospondin 1,THBS-1)、25-羟维生素D3[25-hydroxyvitamin D3,25(OH)D3]、一氧化氮合酶(nitric oxide synthase,NOS)]、舒适度[舒适状况量表(General Comfort Questionnaire,GCQ)]、心理情绪[焦虑自评量表(Self Rating Anxiety Seale,SAS)、抑郁自评量表(Self-Rating Depression Scale,SDS)]、妊娠结局指标[不良妊娠结局发生率、环氧合酶-2(cyclooxyge-nase-2,COX-2)、基质金属蛋白酶-1(matrix metalloproteinase-1,MMP-1)]。结果 观察组产妇产后出血率低于对照组,产后2 h、24 h出血量低于对照组,组间比较差异均有统计学意义(P<0.05)。观察组产妇THBS-1、25(OH)D3高于对照组,NOS低于对照组,差异均有统计学意义(P<0.05)。两组产妇干预前GCQ舒适度评分比较差异无统计学意义(P>0.05);干预后,观察组产妇GCQ舒适度评分高于对照组,差异有统计学意义(P<0.05)。两组产妇干预前SAS评分、SDS评分比较差异无统计学意义(P>0.05);干预后,观察组产妇SAS评分、SDS评分低于对照组,差异有统计学意义(P<0.05)。观察组产妇不良妊娠结局发生率低于对照组,差异有统计学意义(P<0.05)。观察组产妇COX-2、MMP-1低于对照组,差异有统计学意义(P<0.05)。结论 经阴道分娩产妇在分娩过程中接受基于根因分析法的预见性护理干预,能让产妇在分娩过程中保持良好情绪,提升分娩舒适度,降低产后出血量和不良妊娠结局。
Objective To explore the effects of anticipatory nursing intervention based on root cause analysis on postpartum hemorrhage and comfort level of women with transvaginal delivery.Methods 120 cases of transvaginal delivery admitted to the hospital from June 2022 to April 2023 were selected as the study subjects,they were divided into the control group and the observation group according to the principle of balanced and comparable data between the groups,with 60 cases in each group.The control group received conventional nursing care,the observation group received predictive nursing intervention based on the root cause analysis method,comparing the postpartum hemorrhage status and hemorrhage-related indexes[postpartum hemorrhage rate,hemorrhage volume at 2 h and 24 h postpartum,platelet-responsive protein 1(THBS-1),25-hydroxyvitamin D3[25(OH)Vitamin D3,25(OH)D3],nitric oxide synthase(NOS),comfort[General Comfort Questionnaire(GCQ)],psychological mood[Self-rating Anxiety Seale(SAS),Self-rating Depression Scale(SDS)],pregnancy outcome indicators[incidence of adverse pregnancy outcomes,cyclooxyge-nase-2(COX-2),matrix metalloproteinase-1(MMP-1)].Results The rate of postpartum hemorrhage in the observation group was lower than that in the control group,and the amount of hemorrhage at 2 h and 24 h postpartum was lower than that in the control group,and the differences between the groups were statistically significant(P<0.05).Maternal THBS-1 and 25(OH)D3 in the observation group were higher than those in the control group,and NOS was lower than that in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in maternal GCQ comfort scores between the two groups before intervention(P>0.05).After intervention,maternal GCQ comfort scores in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the comparison of maternal SAS scores and SDS scores between the two groups before intervention(P>0.05);After intervention,maternal SAS scores and SDS scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of maternal adverse pregnancy outcomes in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Maternal COX-2 and MMP-1 in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Transvaginal delivery mothers receive anticipatory nursing interventions based on root cause analysis during labor and delivery,which can keep mothers in good emotion statue during labor and delivery,improve labor and delivery comfort,and reduce postpartum hemorrhage and adverse pregnancy outcomes.
作者
李敏
马艳
郝晓园
周伟
郭丽伟
LI Min;MA Yan;HAO Xiaoyuan;ZHOU Wei;GUO Liwei Xuzhou(Mining Group General Hospital,Xuzhou 221006,China)
出处
《护理实践与研究》
2024年第4期596-602,共7页
Nursing Practice and Research
基金
江苏省妇幼保健协会科研项目(编号:FYX202221)。
关键词
阴道分娩
根因分析法
预见性护理干预
出血
舒适度
妊娠结局
Vaginal delivery
Root cause analysis
Anticipatory nursing intervention
Bleeding
Comfort level
Pregnancy outcome
