剖宫产术后中医护理应用及其对盆膈裂孔参数、感染率和应激指标的影响

Application of TCM Nursing after Cesarean Section and Its Impact on the Parameters of Pelvic Diaphragm Hiatus,Infection Rate and Stress Index

目的:探讨中医护理对剖宫产后产妇盆膈裂孔参数、感染率、应激指标和社会功能的影响。方法:将剖宫产产妇132例依据产妇入院顺序分为常规组和研究组各66例。常规组采用常规护理措施,研究组采用中医综合护理方案。比较两组产妇术后盆膈裂孔参数、感染率、腰背痛程度和应激指标前列腺素(prostaglandin,PG)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH),测定两组产妇下肢肌力分布和社会功能评定量表(social function rating scale,SFRS)评分。结果:研究组产妇术后感染率低于常规组,差异具有统计学意义(P<0.05);研究组产妇术后48、72 h腰背痛评分、血清PG、ACTH水平均低于常规组,差异具有统计学意义(P<0.05);研究组产妇剖宫产后6 h肌力为5级的比例高于常规组,差异具有统计学意义(P<0.05);研究组产妇盆膈裂孔前后径(urogenital hiatus anteroposterior diameter,HAP)、总面积(area urogenital hiatus,HA)和孔左右径(urogenital hiatus left right diameter,HLR)均低于常规组,差异具有统计学意义(P<0.05);研究组SFRS评分低于常规组,差异具有统计学意义(P<0.05)。结论:中医护理能增强产妇盆底肌力和下肢肌力,减轻剖宫产后产妇盆底结构损伤,降低术后腰背痛程度和生殖系统感染发生率,能促进产妇恢复社会功能。

Objective:To explore the effects of TCM nursing on the parameters of pelvic diaphragm hiatus,infection rates,stress index and social function of puerperants after cesarean section.Methods:All 132 patients were allocated to conventional group and the study group according to admission order,66 cases each group.Conventional group adopted conventional nursing measures,and the study group TCM comprehensive nursing regimen.To compare the parameters of pelvic diaphragm hiatus,infection rates,the degree of low back pain,stress indexes including PG and ACTH between both groups after treating,to detect muscle strength distribution of lower limbs and SFRS scores.Results:The study group was lower than the conventional group in postoperative infection rate,and the difference had statistical meaning(P<0.05);the scores of low back pain 48 and 72 hours after the operation,the levels of PG and ACTH in the study group were lower than these of the conventional group,and the difference was statistically significant(P<0.05);The ratio of muscle strength at grade five six hours after Cesarean section in the study group was higher than that of the conventional group,and there was a significant difference(P<0.05);the study group was higher than the conventional group in HAP,HA and HLR,and there was a significant difference(P<0.05),the study group was lower than the conventional group in SFRS scores,and the difference had statistical meaning(P<0.05).Conclusion:TCM nursing could enhance the strength of pelvic floor muscle and muscle strength of lower limb,relieve pelvic floor injury,reduce the degree of low back pain and the incidence of reproductive tract infection,and promote the recovery of social function of puerperants after cesareansection.