探讨全方位针对性护理干预对妊娠期甲状腺功能减退症患者的护理效果

Explore the nursing eff ect of all-round targeted nursing intervention on patients with thyroid dysfunction during pregnancy

目的探讨全方位针对性护理干预对妊娠期甲状腺功能减退症患者的护理效果。方法选取68例妊娠期甲状腺功能减退症患者,按照随机数字表法分为对照组与观察组,每组34例。对照组予以常规护理,观察组在对照组基础上予以全方位针对性护理干预。比较两组患者入院时、临产前1 d心理状态、促甲状腺激素(TSH)、游离甲状腺素(FT_(4))水平及母婴结局。结果入院时,两组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分比较,差异无统计学意义(P>0.05);临产前1 d,两组SAS、SDS评分均明显低于入院时,且观察组低于对照组,差异具有统计学意义(P<0.05)。入院时,两组患者TSH、FT_(4)水平比较,差异无统计学意义(P>0.05);临产前1 d,两组TSH水平明显低于入院时,FT_(4)水平高于入院时,且观察组TSH水平明显低于对照组,FT4水平高于对照组,差异具有统计学意义(P<0.05)。观察组早产、胎儿生长受限、胎儿宫内窘迫、胎膜早破以及低体质量儿发生率分别为2.94%、2.94%、0、5.88%、8.82%,均明显低于对照组的23.53%、26.47%、17.65%、23.53%、29.41%,差异具有统计学意义(P<0.05),两组流产、新生儿死亡发生率比较,差异无统计学意义(P>0.05)。结论全方位针对性护理干预可有效改善妊娠期甲状腺功能减退症患者心理状态,促进甲状腺功能恢复,降低不良妊娠结局发生率。

Objective To explore the nursing effect of all-round targeted nursing intervention on patients with hypothyroidism during pregnancy.Methods 68 patients with hypothyroidism during pregnancy were selected and divided into control group and observation group according to random number table method,34 cases in each group.The control group was given routine nursing,and the observation group was given all-round targeted nursing intervention on the basis of the control group.Psychological state,thyroid stimulating hormone(TSH),free thyroxine(FT4)levels and maternal and infant outcomes of 2 groups were compared at admission and 1 day before delivery.Results At admission,there was no significant difference in the scores of SAS and SDS between the two groups(P>0.05).1 day before parturition,SAS and SDS scores in both groups were signifi cantly lower than those at admission,and observation group was lower than control group,the difference was statistically signifi cant(P<0.05).At admission,there was no signifi cant difference in TSH and FT4 levels between 2 groups(P>0.05).On day 1 before parturition,TSH level of the two groups was signifi cantly lower than admission,and FT4 level was higher than admission,and TSH level of the observation group was signifi cantly lower than control group,and FT4 level was higher than control group,the difference was statistically signifi cant(P<0.05).The incidence of premature delivery,fetal growth restriction,fetal distress,premature rupture of membranes and low body weight in the observation group were 2.94%,2.94%,0,5.88%and 8.82%,respectively,which were signifi cantly lower than those in the control group(23.53%,26.47%,17.65%,23.53%,29.41%).The difference was statistically signifi cant(P<0.05),and there was no signifi cant difference in the incidence of abortion and neonatal death between the two groups(P>0.05).Conclusion All-round targeted nursing interventions can effectively improve the psychological state of patients with thyroid dysfunction in pregnancy,promote resumption of thyroid function,reduce incidence of adverse pregnancy.