心理护理结合分娩镇痛降低子痫前期孕妇剖宫产率的临床应用

Clinical application of psychological nursing combined with labor analgesia in reducing cesarean section rate of preeclampsia pregnant women

目的心理护理结合分娩镇痛降低子痫前期孕妇剖宫产率的临床应用。方法选择我院于2017年1月～2018年4月间收治的68例子痫前期孕妇,按照随机数字表法将孕妇划分为观察组与对照组各34例,为观察组孕妇提供心理护理结合分娩镇痛干预,为对照组孕妇提供一般分娩护理服务,评价两组孕妇剖宫产率、镇痛评分、焦虑评分、平均动脉压、镇痛前后血压、新生儿评分及产后出血量。结果观察组孕妇自然分娩率24例(70.59%),高于对照组12例(35.29%);观察组孕妇剖宫产率10例(29.41%),低于对照组22例(64.71%),(χ2=25.008,P <0.05)。观察组孕妇第一产程用时低于对照组(P <0.05)。镇痛前两组孕妇收缩压、舒张压水平均较高,结果比较差异无统计学意义(t=1.608、1.567,P> 0.05);镇痛后观察组患者收缩压、舒张压均低于对照组(t=2.657、9.340,P <0.05)。观察组孕妇在宫口开全时、胎儿娩出后、产后2h时平均动脉压均低于对照组(P <0.05)。两组镇痛评分比较差异无统计学意义(P> 0.05);观察组孕妇焦虑评分低于对照组(t=9.823,P <0.05)。结论为子痫前期孕妇提供心理护理结合分娩镇痛干预,可有效降低孕妇剖宫产率,改善孕妇焦虑评分及高血压状态,缩短第一产程用时。

Objective To explore the clinical application of psychological nursing combined with labor analgesia in reducing cesarean section rate of preeclampsia pregnant women.Methods Sixty-eight pregnant women with preeclampsia admitted to our hospital from January 2017 to April 2018 were selected and divided into observation group and control group according to random number table method,each had 34 cases.The observation group was given psychological nursing combined with labor analgesia intervention,the control group was given general delivery nursing service.Cesarean section rate,analgesia score,anxiety score,mean arterial pressure,blood pressure before and after analgesia,neonatal score and postpartum hemorrhage in the two groups were evaluated.Results The natural delivery rate in the observation groupwas 24 cases(70.59%),which was higher than that of 12 cases(35.29%)in the control group.The cesarean section rate in the observation group was 10 cases(29.41%),which was lower than that of 22 cases(64.71%)in the control group(χ^2=25.008,P<0.05).The duration of the first stage of labor in the observation group was lower than the control group(P<0.05).The systolic and diastolic blood pressures of pregnant women in the two groups before analgesia were higher,but the results were not statistically significant(t=1.608、1.567,P >0.05).After analgesia,the systolic and diastolic blood pressures in the observation group were lower than the control group(t=2.657、9.340,P<0.05).The mean arterial pressurein the observation group was lower than the control group at the time of uterus opened to the full extent,after the delivery of the fetus and 2 hours postpartum,P<0.05.There was no significant difference in analgesic score between the two groups(P >0.05);the anxiety score of pregnant women in the observation group was lower than the control group(t=9.823,P<0.05).Conclusion Psychological nursing combined with labor analgesia intervention for preeclampsia pregnant women can effectively reduce the cesarean section rate,improve anxiety score and hypertension status,shorten the first stage of labor.