心理护理对分娩结局和产时干预的影响

The effects of psychological nursing on outcomes of delivery and obstetrical interference status during labor process

目的 探讨心理护理对分娩结局和产时干预的影响。方法 经 90项症状自评量表 ( SCL-90 )评分伴有心理障碍的产妇 3 68名 ,随机分为心理护理组 ( 1 88名 )和对照组 ( 1 80名 )。心理护理组产妇根据 SCL-90评分在产前、产时给予针对性的心理护理 ;对照组给予常规护理。观察两组产妇的分娩结局 (分娩方式、产程、新生儿窒息、产后出血情况 )和产时干预情况 (胎儿电子监护、缩宫素使用、硬膜外麻醉镇痛、会阴侧切、人工破膜 )。结果 心理护理组产妇自然分娩率 ( 72 .3 % )高于对照组 ( 4 2 .2 % ) ,阴道手术产、剖宫产、新生儿窒息、产后出血、硬膜外麻醉镇痛、缩宫素使用、人工破膜率 ( 5 .4%、2 2 .3 %、1 .6%、3 .7%、1 7.1 %、47.9%、48.0 % )均低于对照组 ( 1 1 .7%、46.1 %、5 .6%、6.7%、3 7.9%、73 .6%、66.7% ) ,P<0 .0 5或 <0 .0 1 ) ,两组经阴道分娩产程时间无明显差异 ( 5 1 6± 1 3 8分 ,5 5 6± 1 5 0分 ) ( P>0 .0 5 )。结论 心理护理可提高自然分娩率 ,降低产妇阴道手术产及剖宫产率 ,减少产后出血和新生儿窒息 ,且经阴道分娩时的助产干预明显较少。

Objective To explore the effects of psychological nursing on outcomes of delivery and obstetrical interference status during labor process.Methods 368 inpatient pregnant women companied with psychological disorders were randomly divided into 2 groups:psychological nursing group(188 cases)and control group(180 cases).The psychological nursing group were given psychological nursing before and during delivery,the control group were nursed with routine model.The outcomes of delivery and obstetrical interference status during labor process were observed and compared between 2 groups.Results The rate of natural delivery in the psychological nursing group(72.3%) was higher than that in the control group(42.2%),the rate of obstetrical vaginal operation、caesarean section、neonatal apnea、postpartum haemorrhage、epidural anesthesia analgesia 、oxytocin induction and artifical caul breakup in the psychological nursing group(5.4%、22.3%、1.6%、3.7%、17.1%、47.9%、48.0%) were all lower than that in the control group(11.7%、46.1%、5.6%、6.7%、37.9%、73.6%、66.7% respectively)(P<0.05,P<0.01).The time of vaginal delivery of 2 groups has no significantly difference(516±138 min vs 556±150 min)(P>0.05).Conclusion Psychological nursing can increase the rate of natural delivery and reduce the rate of obstetrical vaginal operation、caesarean section、postpartum haemorrhage and neonatal apnea.It can also reduce the obstetrical interference during vaginal delivery.