护理干预对羊膜腔穿刺介入性产前诊断的作用

Effect of nursing intervention on amniocentesis for interventional prenatal diagnosis

目的分析护理干预对羊膜腔穿刺介入性产前诊断的作用。方法 150082例孕中期产前筛查孕妇中,部分高危孕妇进行羊膜腔穿刺介入性产前诊断,选取其中300例孕妇,随机分为观察组与对照组,各150例。对观察组实施全部护理干预,对照组除心理干预外同观察组。观察所有产前筛查孕妇中高风险、高龄孕妇和无创胎儿DNA筛查阳性发生情况及其接受介入性产前诊断情况等,并比较两组护理干预前、护理干预后入穿刺室时的心率、收缩压、舒张压水平。结果 150082例孕中期产前筛查孕妇中,21三体综合征和18三体综合征高风险孕妇7430例、门诊高龄孕妇4356例、无创胎儿DNA筛查阳性孕妇,其中5609例进行羊膜腔穿刺介入性产前诊断。5609例羊膜腔穿刺介入性产前诊断孕妇,未出现流产、感染、胎膜早破等不良症状,一针穿刺成功5600例,另9例孕妇因高度紧张,导致胎儿活动而不利于穿刺,经过进一步宣教、休息后第二次穿刺成功。护理干预前两组心率、收缩压、舒张压比较差异无统计学意义(P>0.05);护理干预后入穿刺室时,观察组心率、收缩压、舒张压均明显优于对照组,差异均具有统计学意义(P<0.05)。结论护理干预可有效减轻羊膜腔穿刺介入性产前诊断孕妇及家属的心理负担,有利于顺利完成穿刺操作,提高孕妇的依从性和穿刺成功率。

Objective To analyze the effect of nursing intervention on amniocentesis for interventional prenatal diagnosis. Methods Among 150082 pregnant women with mid-pregnancy prenatal screening, some high-risk pregnant women underwent amniocentesis for interventional prenatal diagnosis. Among them, 300 pregnant women were randomly divided into observation group and control group, with 150 cases in each group. The observation group received all nursing interventions, and the control group received the same nursing with observational groups in addition to psychological intervention. The incidence of DNA positive pregnant women in high-risk, elderly and noninvasive fetuses, and the incidence of antenatal prenatal diagnosis. The heart rate, systolic blood pressure and diastolic blood pressure were compared between the two groups before and after nursing intervention. Results Among 150082 pregnant women with mid-pregnancy prenatal screenings, 7430 women with high risk of trisomy 21 and trisomy 21, 4356 pregnant women with advanced age and positive noninvasive fetal DNA screening, and 5609 cases received amniocentesis for prenatal diagnosis. 5609 pregnant women with amniocentesis for interventional prenatal diagnosis had no adverse symptoms, such as abortion, infection and premature rupture of membranes. 5600 cases were successfully punctured with one needle, and the other 9 cases had fetal activity and unprofitable puncture due to high tension. After further education and rest, they had a second time puncture, and it was successful. Before nursing intervention, both groups had no statistically significant difference in heart rate, systolic blood pressure, diastolic blood pressure（P〈0.05）. After nursing intervention, the observation group had obviously better heart rate, systolic blood pressure, diastolic blood pressure than the control group, and their difference was statistically significant（P〈0.05）. Conclusion Nursing intervention can effectively reduce the psychological burden of pregnant women and their families with amniocentesis for interventional prenatal diagnosis, and is conducive to the successful completion of the puncture operation, so as to improve the compliance of pregnant women and puncture success rate.