乙型肝炎病毒携带者合并妊娠的孕期健康教育效果分析

Analysis on effects of pregnancy health education in hepatitis B virus carriers with pregnancy

目的探讨孕期健康教育对乙型肝炎病毒(HBV)携带者合并妊娠的自我保护行为和肝功能以及妊娠并发症的影响。方法将100例HBV携带者合并妊娠患者采用随机数字表法分为试验组64例和对照组36例进行孕期健康教育。两组均接受门诊及电话随访,结合患者的行为习惯与其共同设立行为改变目标,定期评估目标达成情况;试验组每月召集患者进行集体活动,予以内容和形式多样的健康教育与行为干预。每月评价两组患者丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、清蛋白、总胆红素、直接胆红素、体质量指数及自护行为的改变情况,以及两组患者的妊娠剧烈呕吐、流产、胎儿畸形、妊娠期高血压疾病、产后出血、早产、死胎、母婴传播等并发症的发生率。结果孕期干预后,试验组各项指标均好于对照组,差异有统计学意义(P<0.05)。结论持续的健康教育与行为干预能促使HBV携带者合并妊娠的患者建立并维持良好的习惯,改善肝功能,降低并发症的发生率。

Objective To evaluate the effect of pregnancy health education on the self-care behaviors,liver function indices and complications in the hepatitis B virus carriers with pregnancy. Methods 100 hepatitis B virus carriers with pregnancy were divided into the experimental group（64 cases）and the control group（36 cases） acording to the rondam number table. All patients were performed the pregnancy health education. The two groups received the clinic and telephone follow up. The behavior changing goals were jointly established in combination with their behavior habits, and the goal-reaching situation was evaluated at regular intervals. In addition, the experimental group participated in the collective activities monthly and received the health education and behavioral intervention with various contents and forms. The change situation of ALT, ALB,TBILI, IBILI, BMI and the self-care behaviors were evaluated monthly. The occurrence rates of complications such as hyperemesis gravidarum, abortion, fetal malformations, hypertensive disorders in pregnancy, postpartum hemorrhage, premature birth, stillbirth and mother-to-fetus transmission were compared between the two groups. Results After the pregnancy intervention, the various indices in the experimental group were significantly better than those in the control group, the difference showing statistical significance （P〈0.05）. Conclusion Persistent health education and behavioral intervention could help the hepatitis B virus carriers with pregnancy to establish and maintain the good habits, improve the liver function and reduce the occurrence rate of complications.