认知行为干预在剖宫产产妇中的应用效果观察

The impact of cognitive behavior therapy on postoperative nosocomial infections in puerpera undergoing cesarean section

目的探讨认知行为干预对产妇剖宫产术后医院感染的的影响,为剖宫产后护理提供指导。方法回顾性收集2013年3月—2015年3月行剖宫产的640例产妇资料,根据护理方式的不同分为对照组和干预组,各320例。两组产妇均接受剖宫产常规产科护理,干预组在此基础上给予认知行为干预,比较两组产妇入院时、术后第1天及术后第5天皮质醇Cor.水平、术后体温变化、退热时间、感染发生率及感染部位分布情况。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果干预组产妇术后Cor.水平、退热时间及感染发生率低于对照组(均P<0.05),对照组术后感染的部位依次为呼吸道、手术切口、泌尿系统、消化系统、生殖道感染,分别占43.48%、17.39%、17.39%、13.04%、8.70%,干预组感染的部位依次为手术切口、生殖道、呼吸道、泌尿系统、消化系统感染,分别占40%、20%、20%、10%、10%。结论认知行为干预可以降低剖宫产后血清Cor.水平,降低术后感染的发生率。

Objective The study was conducted to explore the effect of cognitive behavior therapy on postoperative nosocomial infections in puerpera with cesarean section, providing a guidance for nursing care after cesarean section.Methods From March 2013 to March 2015, a total of 640 cases of puerpera with cesarean section were randomly divided into an intervention group and a control group, 320 cases in each group. Puerperas in both groups were subjected to obstetric routine nursing care, and the intervention group was also treated with cognitive-behavioral interventions. The change of cortisol（Cor.） level of two groups were compared when entering the hospital and in postoperative 1 day and 5 day, the factors of body temperature, cooling time, infection rate and infection sites of two groups after operation were recorded.Measurement data were compared by t test and enumeration data were compared by χ^2 test. P〈0.05 was considered statistically significant.Results In intervention group, the Cor. level,cooling time, and infection rate in post-operation was significantly less than that of the control group（all P〈0.05）.Among the 23 puerperas with the postpartum infections in control group, 43.48% the respiratory system infections, 17.39% were the surgical incision infections,17.39% the urinary tract infections,13.04% the digestive system infections,8.70% the genital tract infections. While among the 10 puerperas with the postpartum infections in intervention group,40% were the surgical incision infections,20% the genital tract infections, 20% the respiratory system infections,10% the urinary tract infections,10% the digestive system infections.Conclusion Cognitive behavior intervention can reduce the level of serum Cor. after caesarean section and reduce the incidence of postoperative infection.