产褥期细节优化护理对自然分娩初产妇产后康复的价值评价

Puerperal detail optimized care for rehabilitation of primiparae after natural delivery

目的探讨产褥期细节优化护理对自然分娩初产妇产后康复的价值评价。方法选取2013年l至4月在本院分娩的90例产褥期初产妇为研究对象，随机分为对照组和研究组，各45例。对照组患者实施常规的产后护理，观察组在对照组的基础上实施细节优化护理干预，包括个体化心理疏导、营养饮食、早期中医足浴与子宫物理康复按摩等。比较两组患者产后生理康复指标及心理康复评价。结果通过实施不同的护理干预措施，观察组切口总愈合率100．0％（26／26），明显高于对照组的60．7％（17／28）。产后宫缩痛评分、晚期产后出血率均低于对照组，泌乳始动时间、宫缩痛持续时间、恶露时间均短于对照组；同时观察组在出院时、产后42d的SDS及SAS评分均低于对照组，组间差异均有统计学意义（P〈0．05）。结论对自然分娩初产妇产褥期实施细节优化护理，可有效促进其产后康复，减少产褥感染、尿潴留等产后并发症发生，使产妇掌握科学的自我护理和生活方式，提高产褥期的健康和生活质量，同时增强初产妇适应新角色的信心和能力，使产科护理质量得到保证，临床价值较高，值得进一步推广。

Objective To study the value puerperal detail optimized care for rehabilitation of pdmiparae after natural delivery. Methods 90 puerperal primiparae delivered at our hospital from January to April, 2013 were selected as study objects and were randomly divided into a control group and a study group, 45 for each group. The control group were routinely cared after childbirth; in addition, the study group were intervened with puerperal detail optimized care, including individual psychological counseling, nutrition, diet, early foot bath with Chinese medicine, uterine massage, physical recovery etc. The rehabilitation postpartum physiological and psychological indexes were compared between these two groups. Results The total incision- healing rate of the study group was 100.0% （26/26）, which was significantly higher than that of the control group [60.7% （17/28）]. The Harem shrinkage pain score and the incidence of late postpartum hemorrhage were lower and the lactation initiating time, contractions pain duration, and lochia time were shorter in the study group than in the control group than the control group. When discharging and 42 day after childbirth, the scores of SDS and SAS were lower in the study group than in the control group, with statistical differences （P〈0.05）. Conclusions Puerperal detail optimized care for rehabilitation of primiparac after natural delivery can postpartum recovery, reduce puerperal infection, urinary retention, and other postpartum complications, help the primiparae command scientific self-care and life way, improve their puerperal health and life quality and their confidence and ability in new role adaption, and guarantee the nursing quality. It has high clinical value and is worth being generalized.