麦角新碱联合缩宫素预防高危孕产妇剖宫产产后出血的临床观察及护理干预

Clinical Observation and Nursing Interventions of Ergometrineplus Oxytocin in Preventing the Postpartum Hemorrhage of High-Risk Pregnant Women Following Cesarean Section

目的:探析麦角新碱联合缩宫素预防高危孕产妇剖宫产产后出血的临床效果,并总结护理干预的应用体会。方法:临床纳入150例存在出血高危因素行剖宫产术的孕产妇作为研究对象,入院时间2018年1月~2020年1月,按照随机数字表法分为观察1组、观察2组和对照组,各50例。对照组使用缩宫素+常规护理;观察1组使用缩宫素+麦角新碱+常规护理;观察2组使用缩宫素+麦角新碱+护理干预,观察并比较3组不同时间点的阴道出血量和疼痛程度、护理前和护理后心理状态以及满意度评价。结果:观察1组和观察2组产时、产后2 h、产后24 h阴道出血量均低于对照组,产后2 h、产后24 h视觉模拟疼痛评分(VAS)低于对照组(P<0.05);观察1组和观察2组产时、产后2 h、产后24 h阴道出血量及VAS评分比较均无统计学差异(P>0.05)。护理前,3组密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)比较无统计学差异(P>0.05);护理后,3组HAMA、HAMD均呈现好转趋势,且观察2组评分低于观察1组与对照组(P<0.05)。观察2组产妇对护理服务工作的总满意度高于观察1组与对照组(P<0.05)。结论:麦角新碱联合缩宫素预防高危孕产妇剖宫产产后出血的临床效果优于单用缩宫素,在用药期间配合护理干预可有效缓解产妇的不良情绪,稳定心理状态,进一步减少产妇的损伤,提高满意度。

Objective:To analysis the clinical effect of ergometrine plus oxytocin in preventing the postpartum hemorrhage in high-risk pregnant women following cesarean section,and summarize suggestions for the nursing interventions.Methods:From January 2018 to January 2020,150 high-risk pregnant women undergoing cesarean section in our hospital were selected and assigned to observation group 1,observation group 2 and control group according to random number table method,with 50 cases in each group.The control group took oxytocin and routine care;observation group 1 took oxytocin,ergometrine and routine care;observation group 2 took oxytocin,ergometrine and nursing interventions.At each time point,the volume of vaginal bleeding and degree of pain as well as mental state and nursing satisfaction before and after nursing were appraised.Results:In observation group 1 and observation group 2,the vaginal bleeding volume upon delivery,at 2 h and 24 h after delivery was lower than those of the control group.Visual analogue scale(VAS)scores at 2 h and 24 h after delivery were lower than that of the control group(P<0.05).The vaginal bleeding volume and VAS scores upon delivery,at 2 h and 24 h after delivery of observation group 1 and observation group 2 were not significantly different(P>0.05).Before nursing,Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)scores of the three groups were not significantly different(P>0.05).After nursing,HAMA and HAMD scores of all three groups showed an improving tendency,with lower scores found in observation group 2 than observation group 1 and control group(P<0.05).The overall nursing satisfaction in observation group 2 was higher than that of the observation group 1 and control group(P<0.05).Conclusion:Ergometrine combined with oxytocin has better effects for reducing postpartum hemorrhage.Meanwhile,nursing interventions can relieve the negative emotions of high-risk pregnant women,stabilize their mental state,reduce the injury and improve the nursing satisfaction.