路径式健康教育在乙型肝炎孕产妇抗病毒治疗中的应用效果

Application effect of pathway health education on antiviral treatment in hepatitis B pregnant women

目的探讨路径式健康教育对抗病毒治疗乙型肝炎孕产妇自我管理能力及预后的影响。方法选择2016年11月至2017年11月收治的抗病毒治疗乙型肝炎孕产妇120例为研究对象,采用前瞻性研究的方法随机分为干预组和对照组各60例。干预组给予路径式健康教育。比较两组孕产妇自我管理能力、用药依从性、HBV DNA定量、妊娠结局。结果干预组孕产妇治疗管理、躯体活动管理、社会心理管理评分明显高于对照组(t=3.860、3.511、8.375,P<0.05或0.01);用药依从性为96.67%,高于对照组85.00%(χ^2=4.904,P<0.05);干预组孕产妇HBV DNA对数平均值明显低于对照组[(3.56±0.65)vs(3.81±0.71)](t=2.012,P<0.05);干预组孕产妇剖宫产率、早产、产后出血发生率明显低于对照组(41.67% vs 61.67%,13.33% vs 28.33%,18.33% vs 35.00%)(χ^2=4.805、4.093、4.216,P<0.05);干预组婴儿6个月母婴阻断成功率100%明显高于对照组93.33%(χ^2=4.138,P<0.05)。结论路径式健康教育有助于促进抗病毒治疗乙型肝炎孕产妇自我管理能力的养成,提高用药依从性,改善妊娠结局,提高母婴阻断成功率。

Objective To investigate the effect of pathway health education on the self-management ability and prognosis of hepatitis B pregnant women. Methods A total of 120 pregnant women with hepatitis B under antiviral treatments from November 2016 to November 2017 were enrolled. The prospective study was used and the patients were randomly divided into the treatment group (n=60) and the control group (n=60). The control group received routine health education, while the treatment group was given pathway health education. The maternal self-management ability, medication compliance, HBV DNA quantification and pregnancy outcome were compared between the two groups. Results The scores of maternal treatment management, physical activity management and psychosocial management in the treatment group were significantly higher than those in the control group (t=3.860, 3.511 and 8.375, P<0.05 or 0.01). The medication compliance was 96.67%, which was significantly higher than the control group (85.00%)(χ^2=4.904, P<0.05). The mean logarithm of maternal HBV DNA in the treatment group was significantly lower than that in the control group [(3.56±0.65) vs (3.81±0.71)](t=2.012, P<0.05). The incidence rates of cesarean section, premature delivery and postpartum hemorrhage in the treatment group were significantly lower than those in the control group (41.67% vs 61.67%, 13.33% vs 28.33%, 18.33% vs 35.00%)(χ^2=4.805, 4.093 and 4.216, P all <0.05). The blocking the maternal-infant transmission success rate in 6-month infants in the treatment group was 100%, which was significantly higher than that in the control group (93.33%)(χ^2=4.138, P<0.05). Conclusions Pathway health education can promote the development of self-management ability, improve the medication compliance, maternal pregnancy outcome, as well as maternal and child block success rate in hepatitis B pregnant women under antiviral therapy.