基于根因分析法的预见性防范管理降低阴道分娩产妇产后出血的效果观察

Observation on Effects of Predictive Prevention Management Based on Root Cause Analysis on Reducing Postpartum Hemorrhage in Puerperae with Vaginal Delivery

目的:研究基于根因分析法的预见性防范管理降低阴道分娩产妇产后出血的效果。方法:纳入2021年1月-2022年2月抚州市第一人民医院妇产科收治的80例阴道分娩产妇作为研究对象,按照随机数字表法分为对照组(常规护理模式)和观察组(基于根因分析法的预见性防范管理)各40例。比较两组产后出血情况、出血量,于产后42 d评估两组负性情绪[产后抑郁筛查量表(PDSS)、爱丁堡产后抑郁量表(EPDS)],观察干预前、产后42 d两组舒适度[简化舒适状况量表(GCQ)],统计两组产后恢复情况。结果:观察组产后出血发生率明显低于对照组(P<0.05);生产中、产后2 h和产后24 h,观察组出血量均明显少于对照组(P<0.05)。产后42 d,观察组PDSS、EPDS评分水平均明显低于对照组(P<0.05)。产后42 d,两组GCQ评分水平均较干预前显著上升,观察组均明显高于对照组(P<0.05);两组产后感染、子宫复旧、恶露持续时间、月经复潮时间、第一次月经量、产后月经周期比较差异均无统计学意义(P>0.05)。结论:基于根因分析法的预见性防范管理能够显著降低阴道分娩产妇产后出血风险和出血量,改善产妇心理状态和舒适度,应用效果较好。

Objective:To study the effects of predictive prevention management based on root cause analysis on reducing postpartum hemorrhage in puerperae undergoing vaginal delivery.Method:A total of 80 women with vaginal delivery treated in Department of Obstetrics and Gynecology of the First People’s Hospital of Fuzhou from January 2021 to February 2022 were included as the research subjects.According to the random number table method,the patients were classified into the control group(conventional nursing model) and the observation group(predictive prevention management based on root cause analysis),with 40 cases in each group,the postpartum hemorrhage status and amount of hemorrhage were compared between the two groups,the negative emotions [postpartum depression screening scale(PDSS),Edinburgh postpartum depression scale(EPDS)] were evaluated at 42 d after delivery,and the comfort [general comfort questionnaire(GCQ)] was observed before intervention and at 42 d after delivery,and the postpartum recovery status were statistically analyzed in both groups.Result:The incidence rate of postpartum hemorrhage in the observation group was obviously lower than that in the control group(P<0.05).During delivery,2 h and 24 h after delivery,the amount of hemorrhage in the observation group was significantly less compared to the control group(P<0.05).The scores of PDSS and EPDS at 42 d after delivery in the observation group were markedly lower than those in the control group(P<0.05).The GCQ scores of the two groups at 42 d after delivery were significantly higher than those before intervention,and those in the observation group were significantly higher than those in the control group(P<0.05).There were not statistical differences in the postpartum infection,uterine involution,lochia duration,menstrual recovery time,first menstrual volume and postpartum menstrual cycle between the two groups(P>0.05).Conclusion:Predictive prevention management based on root cause analysis can significantly reduce the risk and amount of postpartum hemorrhage women,improve the psychological state and comfort of women undergoing vaginal delivery,with good application effects.