综合性护理干预对羊膜腔穿刺介入性产前诊断穿刺成功率的影响

Comprehensive Nursing Intervention for Amniocentesis Interventional Prenatal Diagnosis Puncture Impact of Success rate

目的探究综合性护理干预对进行羊膜腔穿刺介入性产前诊断孕妇穿刺成功率的影响以及降低不规则宫缩等不良并发症的发生率。方法选取2017年1月至2020年12月本院1956例于产前诊断中心进行羊膜腔穿刺的孕妇,按照随机数字表法分为观察组和对照组,各978例。其中,中孕期血清学产前筛查阳性1163例,高龄467例,无创DNA筛查阳性46例,超声诊断异常260例,孕妇本人或配偶有染色体异常20例。对照组采用常规护理干预,观察组采用综合性护理干预。评估所有中孕期血清学产前筛查孕妇中高风险、高龄孕妇和无创胎儿DNA筛查阳性,超声诊断异常、孕妇本人或配偶染色体异常发生情况及其接受介入性产前诊断情况等,并评估一次性穿刺成功率、干预后的收缩压、舒张压、心率的波动情况,不良症状的发生率。结果观察组一次性穿刺成功率高于对照组(P<0.05);观察组入羊膜腔穿刺时收缩压、舒张压、心率的波动幅度低于对照组(P<0.05);观察组不规则宫缩、阴道出血、羊膜腔穿刺前后胎心率改变>30次不良症状发生率低于对照组(P<0.05)。结论综合性护理干预应用于进行羊膜腔穿刺介入性产前诊断的产妇能有效提高患者一次性穿刺成功率,降低不良症状的发生。

Objective To explore the effect of comprehensive nursing intervention on the success rate of amniocentesis in pregnant women undergoing interventional prenatal diagnosis and to reduce the incidence of adverse complications such as irregular contractions.Methods There were 6179 cases of amniocentesis in our hospital since July 2011 when interventional prenatal diagnosis was carried out.A total of 1956 pregnant women who underwent amniocentesis in prenatal diagnosis center of our hospital from January 2017 to December 2020 were selected and divided into observation group and control group according to simple random number table method,with 978 cases in each group.Among them,there were 1163 positive cases of serological prenatal screening in the middle pregnancy,467 elderly cases,46 positive cases of non-invasive DNA screening,260 abnormal cases of ultrasound diagnosis,and 20 cases of chromosomal abnormalities in the pregnant women or their spouses.The control group was treated with routine nursing intervention,and the observation group was treated with comprehensive nursing intervention.All pregnant women with serological prenatal screening in the second trimester were evaluated for positive DNA screening of high-risk,elderly pregnant women and non-invasive fetus,abnormal ultrasound diagnosis,occurrence of chromosome abnormalities in pregnant women or their spouses and receiving interventional prenatal diagnosis,and the success rate of one-time puncture,fluctuations in systolic blood pressure,diastolic blood pressure and heart rate after intervention,and the incidence of adverse symptoms.Results The success rate of one-time puncture in observation group was higher than that in control group(P<0.05).The fluctuations of systolic blood pressure,diastolic blood pressure and heart rate in the observation group were lower than those in the control group(P<0.05).The incidence of irregular contractions,vaginal bleeding,fetal heart rate changes>30 times before and after amniocentesis in observation group was lower than that in control group(P<0.05).Conclusions The application of comprehensive nursing intervention in the prenatal diagnosis of amniocentesis can effectively improve the success rate of one-time puncture and reduce the occurrence of adverse symptoms.