综合护理干预在输卵管妊娠保守治疗中的应用效果观察

Application effect of comprehensive nursing intervention on conservative treatment of tubal pregnancy

目的探讨综合护理干预在输卵管妊娠保守治疗中的护理效果。方法选择2015年6月至2016年1月科室收治的输卵管妊娠患者70例,并随机等分为对照组和观察组。所有患者均行保守治疗,对照组采用常规方法护理;观察组采用综合护理干预。记录两组患者护理后血β-h CG降至正常时间、住院时间、住院费用、包块消失时间及月经恢复正常时间;两组患者护理后行子宫输卵管碘油造影,拍摄X线片,评价输卵管情况,对患者进行2年随访记录两组妊娠情况;采用免疫化学发光法测定两组患者护理前后卵泡雌激素(FSH)、雌二醇(E2)及黄体生成素(LH)水平,比较两组护理效果及对患者输卵管、卵巢功能的影响。结果两组患者护理后住院时间、住院费用比较无统计学意义(P>0.05);观察组护理后血β-h CG降至正常、包块消失时间及月经恢复正常时间均短于对照组(P<0.05);观察组护理后患侧输卵管通畅、自然宫内妊娠率均高于对照组(P<0.05);两组护理后LH水平比较差异无统计学意义(P>0.05);观察组护理后FSH,E2水平均低于对照组(P<0.05)。结论综合护理干预用于输卵管妊娠保守治疗中有助于缩短症状改善时间,能提高患者输卵管、卵巢功能,改善妊娠结局,值得推广应用。

Objective To explore the nursing effect of comprehensive nursing intervention on conservative treatment of tubal pregnancy. Methods To select 70 patients with tube pregnancy admitted into our department from June 2015 to January 2016,randomly divided them into control group and observation group. All patients were given conservative treatment,and control group was given routine nursing; while the observation group was given comprehensive nursing intervention. To record serum β-h CG returned to normal time after nursing,hospital stays,hospitalization expenses,masses disappearing time and menstruation recovery time of two groups; Two groups of patients underwent hysterosalpingography after nursing,X-rayfilm were taken to evaluate the situation of fallopian tubes,two-year follow-up of patients were recorded in two groups of pregnancies; using immunochemiluminescence method to determine follicle-stimulating hormone（ FSH）,estradiol（ E2） and luteinizing hormone（ LH） before and after care in both groups were compared to compare the effect of nursing in both groups and the effect on the oviduct and ovary function. Results There was no statistically significant difference in hospitalization time and hospitalization expenses between the two groups（ P〉0. 05）; after the nursing,the serum β-h CG level returned to normal,the disappearance time of the mass and the menstrual recovery time were all shorter than those of the control group（ P〈0. 05）; the tubal patency and natural intrauterine pregnancy rate were higher in the observation group after nursing than in the control group（ P〈0. 05）; there was no statistically significant difference in LH levels between the two groups after nursing（ P〉0. 05）; the FSH and E2 levels in the observation group were lower than those in the control group after nursing（ P〈0. 05）. Conclusion Comprehensive nursing interventions for conservative treatment of tubal pregnancy can shorten the time for symptom improvement,improve the patient＇s fallopian tube and ovarian function,and improve pregnancy outcomes,which was worth popularizing and applying.