临床护理路径在预防产后晕厥中的应用价值

Application of clinical care pathway in the prevention of postpartum syncope

目的探讨临床护理路径在预防产后晕厥中的应用效果。方法 2010年1～9月根据Nesbitt高危评分表对汕头大学医学院第一附属医院产科200例有阴道分娩意愿的孕妇进行评估,按随机数字表将孕妇分为观察组和对照组,每组各100例。两组孕妇均在产前进行母乳喂养宣教,入病室及产房时发放护理安全告知书及以常规护理,观察组根据制订的自然分娩临床护理路径表由责任护士进行专职护理。对比两组产妇分娩的产程时间、血压及产后昏厥发生情况。结果观察组和对照组总产程时间分别为（629.0±157.7）min和（710.0±192.2）min;产后下床前收缩压分别为（122.7±5.3）mm Hg（1 mm Hg=0.133 kPa）和（105.6±6.4）mm Hg;产后晕厥发生率分别为1%和10%;两组比较差异均有高度统计学意义（均P〈0.01）。结论临床护理途径可有效防止产后晕厥的发生,降低病区意外事件发生率。

Objective To investigate the effects of clinical care pathway on preventing postpartum syncope. Methods200 expectant mothers demand to vaginal delivery from January to September 2012 in Department of Obstetrics of the First Affiliated Hospital of Medical College of Shantou University were evaluated according to high-risk score chart Nesbitt, and they were randomly divided into observation group and control group according to the random number table, 100 cases in each group. Both groups were given the breast feeding promotion, nursing safety notice before entering the delivery room, and conventional care. Specially, the observation group simultaneously was received full-time care by nurses according to the clinical pathway of natural childbirth. Maternity patients＇ time of labor stage, blood pressure, and postpartum syncope were compared in the two groups. Results The total labor time of the observation group and control group were（629.0±157.7） min and（710.0±192.2） min respectively; the postpartum systolic blood pressure before leaving the bed in two groups were（122.7±5.3） mm Hg（1 mm Hg=0.133 kPa） and（105.6±6.4） mm Hg respectively, and the rate of postpartum syncope were 1% and 10% respectively, the difference of two were statistically significant（all P〈0.01）. Conclusion Clinical care pathway play an important roles in preventing postpartum syncope and reducing accidents in wards.