妊娠期高血压肝功能损害患者的护理及其妊娠结局

Nursing of hypertensive disorder complicating pregnancy patients with liver function impairment and their pregnancy outcomes

目的探讨护理干预对于妊娠期高血压(HDCP)肝功能损害患者的孕期及产后结局与其围产儿结局的影响。方法选取我院收治的HDCP患者,从中选出合并肝损害的患者150例,随机分为两组,分别予以优质护理和常规护理进行干预,另选单纯HDCP患者作为对照组,观察三组患者的血压、肝功、产后出血量、胎盘早剥、剖宫产和早产等妊娠结局以及围产儿的相关结局。结果与对照组相比,常规组和护理组的患者ALT和AST指标及产后出血量均明显升高,剖宫产人数也增加,差异有统计学意义(P<0.05),具有肝功能损害的患者剖宫产干预更多并且并发产后出血仍较严重;与常规组相比,护理组的ALT和AST水平明显下降,产后出血量和剖宫产人数也减少,差异有统计学意义(P<0.05)。护理组围产儿的生长情况以及其他并发症与对照组相比无明显差异,而与常规组相比,生长受限、胎儿窘迫、窒息和死亡的并发症明显减少,差异具有统计学意义(P<0.05)。结论良好的护理在HDCP合并肝功能损害的患者孕期和产程中均有良好的帮助,可显著降低不良妊娠结局和不良新生儿结局的发生率,值得临床推广应用。

Objective To explore the effect of nursing intervention to the pregnancy, postpartum outcomes and perinatal outcome of hypertensive disorder complicating pregnancy patients with liver function impairment. Methods Patients with HDCP cured in our hospital were selected, 150 cases of patients with liver injury were selected from them. They were randomly divided into two groups, and they were given high-quality nursing and routine nursing intervention respectively. Simple HDCP patients were selected as control group. Blood pressure, liver function, postpartum hemorrhage, placental abruption, cesarean section, premature delivery and pregnancy outcome and perinatal outcome of the three groups were observed. Results Compared with control group, ALT and AST index and postpartum hemorrhage of routine group and nursing group were obviousle increased. The number of cesarean section also increased, The difference was statistically significant （P 〈 0.05）. Patients with liver function impairment were more involved in cesarean section and complicated with postpartum hemorrhage. Compared with routine group, ALT and AST levels of nursing group were obviously decreased, the amount of postpartum hemorrhage and the number of cesarean section also decreased, and the difference was statistically significant （P 〈 0.05）. There was no significant difference on perinatal growth and other complications between nursing group and control group. Compared with routine group, complications of growth restriction, fetal distress, asphyxia and death of nursing group were obviously reduced, and the difference was statistically significant （P 〈 0.05）. Conclusion Good nursing has good help in patients with HDCP complicated with liver dysfunction during pregnancy and labor. It can significantly reduce adverse pregnancy outcomes and incidence of adverse neonatal outcomes. It is worthy of clinicalpromotion and application.