米索前列醇联合心理干预预防产妇产后出血的临床观察

Clinical observation of misoprostol combined with psychological intervention in preventing maternal postpartum hemorrhage

目的探讨米索前列醇联合心理干预预防产妇产后出血的效果,为临床预防产后出血提供依据。方法收集2014年3月~2017年3月在宁夏自治区妇幼保健院住院分娩的产妇120例,所有产妇均在胎儿娩出后给予米索前列醇治疗,按是否接受个体化心理干预分为干预组和对照组,其中干预组64例,对照组56例。对照组仅接受常规对症护理,干预组则接受入院时心理干预和产时心理干预。比较2组产妇心理状态、第三产程时间、产后出血发生率、产后24 h出血量、护理满意度和并发症发生情况。结果干预组焦虑、恐惧和抑郁发生率均低于对照组（P〈0.05）。干预组第三产程时间短于对照组,产后出血发生率低于对照组,产后24 h出血量少于对照组,比较差异均有统计学意义（P〈0.05）。干预组的护理满意度为96.88%（62/64）,对照组的护理满意度为78.57%（44/56）,组间比较差异有统计学意义（P〈0.05）。干预组产程延长2例,胎儿宫内窘迫2例,胎盘早剥1例,对照组产程延长3例,胎盘早剥3例,前置胎盘2例。干预组并发症发生率低于对照组,但比较差异无统计学意义。结论米索前列醇联合心理干预可显著改善产妇不良心理状态,降低产后出血发生率,减少出血量,提高护理满意度。

Objective To explore the effect of misoprostol combined with psychological intervention to prevent maternal postpartum hemorrhage,and to provide evidence for clinical prevention of postpartum hemorrhage. Methods 120 cases of delivery in maternal and child health care hospital of Ningxia autonomous region from March 2015-March 2017 were collected. All women were given misoprostol treatment after fetal delivery,according to whether or not to accept the individual psychological intervention were divided into intervention group and control group,64 cases in intervention group,56 cases in the control group. The control group received only routine symptomatic nursing,the intervention group received psychological intervention at the time of admission and postpartum psychological intervention. The maternal mental state,the third stage of labor time,the rate of postpartum hemorrhage,the amount of postpartum hemorrhage of 24 h,the degree of nursing satisfaction and complications were compared between the two groups.Results The incidence of anxiety,fear and depression in the intervention group was lower than that in the control group（ P 〈0. 05）. The third stage of labor in the intervention group was shorter than that in the control group,the incidence of postpartum hemorrhage was lower than that of the control group,and the amount of postpartum hemorrhage of 24 h was less than that of the control group,and the difference was statistically significant（ P〈 0. 05）. The nursing satisfaction of the intervention group was 96. 88%（ 62/64）,and the nursing satisfaction was 78. 57%（ 44/56） in the control group,and the difference was statistically significant between the two groups（ P〈 0. 05）. In the intervention group,two cases were prolonged labor,two cases were fetal distress,one case of placental abruption,in the control group three cases were prolonged labor,three cases of placental abruption,two cases of placenta previas. The incidence of complications in the intervention group was lower than that in the control group,but there was no significant difference.Conclusion Misoprostol combined with psychological intervention can significantly improve maternal adverse psychological status,reduce the incidence of postpartum hemorrhage,reduce bleeding,improve nursing satisfaction.