综合护理干预对剖宫产孕妇应激反应的影响

Impact of integrated care intervention on cesarean stress response

目的探讨剖宫产患者应激反应状况及有效干预对策。方法将80例手术终止妊娠的孕妇随机分为观察组和对照组各40例,对照组实施常规术前护理访视,观察组进行综合护理干预,进行术前干预和术中干预,并在入院后第2天、术前1天、术后第3天采用Zung焦虑自评量表(SAS)进行评分;同时于术前30 min、切皮时、切皮后20 min、术毕四个时点测定SBP、DBP、MAP、HR数值。结果两组产妇在入院时SAS评分均高于50分,组间比较差异无统计学意义(P>0.05),术前1天的SAS评分,观察组的焦虑分值降低,对照组焦虑分值反而增高,两组产妇的焦虑程度差异有高度统计学意义(P<0.01)。对照组切皮时、切皮后20 min的SBP、DBP、MAP、HR值均增高,与术前30 min比较,差异有高度统计学意义(P<0.01),组间比较,差异有高度统计学意义(P<0.01);观察组各项指标差异无统计学意义(P>0.05)。结论对剖宫产孕妇实施综合护理干预可有效降低其应激反应程度和焦虑情绪,调整心理状态,大大提高其对手术、麻醉的耐受能力。

Objective To investigate the cesarean stress response and the effective intervention approach.Methods 80 women for pregnancy termination were randomly divided into the observed group and the control group,40 for each.Preoperative nursing visits were made to the control group.Besides the preoperative nursing visits,integrated care intervention was implemented on the observed group before and during operation,and grading was made with Zung Self-Rating Anxiety Scale（SAS）,on the 2nd day after hospitalization,the day before and the 3rd day after operation.Values of SBP,DBP,MAP,HR were detected on the observed group,separately,30 minutes before operation,during skin incision,20 minutes after incision and right after operation.Results The SAS grades of the two groups were averagely higher than 50 when hospitalized,with no significant difference（P0.05）.The grades of anxiety of the observed group decreased the day before operation while those of the control group increased,showing significant difference（P0.01）.The values of SBP,DBP,MAP,HR of the control group all increased 20 minutes after skin incision,showing significant difference（P0.01）compared to those of 30 minutes before incision.There was significant difference between the two groups（P0.01）.No indexes in the observed group indicated significant difference（P0.05）.Conclusion Integrated care intervention on cesarean can reduce stress response and anxiety,adjust mental sate and strengthen anesthetic endurance.