心理调适能力干预在前置胎盘伴胎盘植入患者剖宫产围术期中的效果及对情绪状态、分娩结局的影响

Effect of psychological adjustment ability intervention in the perioperative period of cesarean section in patients with placenta previa and placenta implantation and its influences on emotional state and delivery outcome

目的探讨心理调适能力干预在前置胎盘伴胎盘植入患者剖宫产围术期中的效果。方法选取2019年7月至2022年2月我院收治的84例前置胎盘伴胎盘植入患者为研究对象,随机将其分为对照组和观察组,每组42例。两组均接受剖宫产手术,对照组实施常规护理干预,观察组在对照组基础上实施心理调适能力干预。比较两组的干预效果。结果产后2 d,两组的汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分均降低,且观察组低于对照组(P<0.05)。手术30 min,观察组的心率(HR)、皮质醇(Cor)水平及平均动脉压(MAP)低于对照组(P<0.05)。产后2、6、24 h,观察组的出血量小于对照组(P<0.05)。两组的分娩不良事件总发生率比较,差异无统计学意义(P>0.05)。结论心理调适能力干预在前置胎盘伴胎盘植入患者剖宫产围术期中的应用效果较好,可改善患者的情绪状态,调节应激反应,减小产后出血量,但对分娩结局无显著改善作用。

Objective To explore the effect of psychological adjustment ability intervention in the perioperative period of cesarean section in patients with placenta previa and placenta implantation.Methods A total of 84 patients with placenta previa and placenta implantation admitted in our hospital from July 2019 to February 2022 were selected as the research objects and randomly divided into control group and observation group,with 42 cases in each group.Both groups received cesarean section,the control group received routine nursing intervention,and the observation group received psychological adjustment ability intervention on the basis of the control group.The intervention effects of the two groups were compared.Results At 2 d after delivery,the scores of Hamilton Depression Rating Scale(HAMD)and Hamilton Anxiety Rating Scale(HAMA)in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).At 30 min of operation,the heart rate(HR),cortisol(Cor)level and mean arterial pressure(MAP)in the observation group were lower than those in the control group(P<0.05).At 2,6 and 24 h after delivery,the amount of bleeding in the observation group was less than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse delivery events between the two groups(P>0.05).Conclusion Psychological adjustment ability intervention in the perioperative period of cesarean section applied in patients with placenta previa and placenta implantation has better effect,which can improve the emotional state of patients,regulate the stress response,reduce the amount of postpartum hemorrhage,but it has no significant effect on the delivery outcome.