循证护理在甲氨蝶呤治疗异位妊娠中的效果观察

Effect observation of evidence-based care on ectopic pregnancy treated by Methotrexate

目的探讨循证护理在异位妊娠采用甲氨蝶呤保守治疗中的应用效果。方法从本院2010年1月~2011年8月收治的异位妊娠患者中选择输卵管异位妊娠患者90例为研究对象,随机分为研究组与对照组,每组各45例。两组患者均给予甲氨蝶呤保守治疗,研究组患者实施循证护理,对照组患者给予常规妇科护理。观察患者治疗效果及两组护理前后心理状态变化、治疗配合、疾病认知等情况的变化,并进行组间比较。结果①治疗效果：本研究输卵管异位妊娠患者90例,保守治疗成功80例,成功率为88.89%,8例因输卵管妊娠破裂、2例因疗效不明显改行手术治疗。患者住院天数为8~22 d,平均12.3 d。②护理效果比较：两组护理后焦虑（HAMA）评分、抑郁（HAMD）评分均较护理前改善,但研究组改善明显优于对照组;护理后研究组患者对药物、治疗及疾病认知程度明显高于对照组;研究组治疗配合率明显高于对照组,有焦虑抑郁、恐惧等不良情绪的患者比例明显低于对照组;以上项目组间差异均有统计学意义（P〈0.05）。结论循证护理可以改善异位妊娠患者不良情绪,增加患者对疾病的认知度,还可以提高护理质量,提高患者治疗舒适度。

Objective To investigate the application effect of evidence-based nursing on ectopic pregnancy treated by Methotrexate.Methods 90 cases of tubal ectopic pregnancy patients were chosen from the ectopic pregnancy cases admitted to our hospital from June 2010 to December 2011 as the study objects.The selected cases were randomly assigned to the study group and the control group,each group had 45 cases.Patients in both groups were all given Methotrexate conservative treatment,while patients in the study group were given evidence-based care and patients in the control group were given routine gynecological care.Treatment efficacy and changes in mental state,treatment cooperation and disease cognitive of patients before and after treatment between the two groups were observed and compared.Results ①Therapeutic effect： among the 90 cases of tubal ectopic pregnancy,conservative treatment was successful in 80 cases,with a success rate of 88.89%.8 cases diverted to surgery due to rupture of tubal pregnancy and 2 cases underwent surgery due to insignificant treatment outcomes.The hospital stay varied from 8 to 22 days,with an average of 12.3 days.②After nursing care,anxiety（HAMA） score and depression（HAMD） score were improved in both groups,but the study group improved significantly better than the control group;knowledge of drug,treatment and disease were significantly better in the study group than the control group;treatment compliant rate was significantly higher in the study group and the proportions of patients with anxiety,depression,fear and other negative emotions were significantly lower in the study group than those of the control group;all the differences were statistically significant（P 〈0.05）.Conclusion Evidence-based care can improve the negative emotions of patients with ectopic pregnancy,increase patients＇ awareness of disease and improve the quality of care,and finally improve patients comfort.