无痛暗示护理干预对无痛分娩产妇产程疼痛、产后出血、新生儿剖宫率、迫降率的影响

目的:探讨无痛暗示护理干预对无痛分娩产妇产程疼痛、产后出血、新生儿剖宫率、迫降率的影响。方法:选取本院于2020年10月至2021年8月收治的92例接受无痛分娩产妇,按照护理模式的不同将其分为研究组和对照组,各46例。对照组产妇采用常规分娩护理,研究组产妇则在对照组基础上使用无痛暗示护理干预。使用视觉模拟评分法(VAS)比较两组产妇各产程的疼痛程度,观察两组产妇各产程时间与产后出血量,并记录两组新生儿剖宫率、迫降率以及窒息率,同时比较两组产妇对护理工作的满意情况。结果:研究组产妇各产程的VAS评分均比对照组低(P<0.05);研究组产妇各产程时间比对照组短,产后出血量比对照组少(P<0.05);研究组新生儿剖宫率、迫降率以及窒息率分别为4.35%、2.17%、2.17%,比对照组的19.57%、13.04%、15.22%低(P<0.05);研究组产妇对于护理工作的满意度为97.83%,比对照组的84.78%高(P<0.05)。结论:对产妇采用无痛暗示护理干预能减少分娩疼痛,缩短产程时间,并能控制产后出血量,对母婴结局的改善有重要意义,可收获较高护理满意评价,具有良好临床应用价值。

Pregnancy Outcomes of Repeat Cesarean Section in Peking Union Medical College Hospital

Objective To evaluate the effect of elective repeat cesarean section on the maternal and neonatal outcomes. Methods A retrospective clinic- and hospital-based survey was designed for comparing the maternal and neonatal outcomes of elective repeat cesarean section [RCS group （one previous cesarean section） and MRCS group （two or more previous cesarean sections）] and primary cesarean section （FCS group） at Peking Union Medical College Hospital from January 1998 to December 2007. Results The incidence of repeat cesarean section increased from 1.26% to 7.32%. The mean gestational age at delivery in RCS group （38.1±1.8 weeks） and MRCS group （37.3±2.5 weeks） were significantly shorter than that in FCS group （38.9±2.1 weeks, all P〈0.01）. The incidence of complication was 33.8% and 33.3% in RCS group and MRCS group respectively, and was significantly higher than that in FCS group （7.9%, P〈0.05）. Dense adhesion （13.5% vs. 0.4%, OR=7.156, 95% CI： 1.7-30.7, P〈0.01） and uterine rupture （1.0% vs. O,P〈0.05） were commoner in RCS group compared with FCS group. Neonatal morbidity was similar among three groups （P〉0.05）. Conclusions Repeat cesarean section is associated with more complicated surgery technique and increased frequency of maternal morbidity. However, the incidence of neonatal morbidity is similar to primary cesarean section.