分娩期全程护理在剖宫产术后阴道试产孕妇中的应用
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摘要
目的探讨分娩期全程护理干预对剖宫产术后阴道试产(trial of labor after cesarean section,TOLAC)孕妇分娩方式、妊娠结局及护理满意度的影响。方法选择2015年1月—2016年12月在桂林医学院附属医院行TOLAC的孕妇562例,随机分为对照组和观察组各281例,对照组给予常规护理,观察组给予拟定的分娩期全程护理干预,比较两组分娩方式、妊娠结局及护理满意度的差异。结果观察组阴道分娩成功率及护理满意度高于对照组,社会因素剖宫产率及出血量低于对照组,差异具有统计学意义(P均<0.05),两组阴道助产、产后出血、新生儿窒息及先兆子宫破裂发生率均无统计学差异(P均>0.05)。结论分娩期全程护理干预可以有效提高TOLAC孕妇的阴道分娩成功率,减少出血量,提高护理满意度。
Objective To explore the influence of whole course nursing on the delivery mode,pregnancy outcomes and nursing satisfaction in the pregnant women with trial of labor after cesarean(TOLAC).Methods The TOLAC pregnant women were collected from The Affiliated Hospital of Guilin Medical College,Guangxi Province from January 2015 to December 2016.They were randomly and equally divided into the control group and observation group.The control group was given the routine nursing and the observation group was given whole course nursing intervention.The delivery mode,pregnancy outcomes and nursing satisfaction between two groups were compared.Results The observation group had higher success rate of vaginal delivery and nursing satisfaction,and lower cesarean rate and bleeding amount(P < 0.05).The rates of delivery aids,postpartum hemorrhage,neonatal asphyxia and uterine rupture had no significant difference(P > 0.05).Conclusion The whole course nursing intervention during delivery can effectively improve the success rate of TOLAC,reduce bleeding amount,and improve nursing satisfaction.
Objective To explore the influence of whole course nursing on the delivery mode,pregnancy outcomes and nursing satisfaction in the pregnant women with trial of labor after cesarean(TOLAC).Methods The TOLAC pregnant women were collected from The Affiliated Hospital of Guilin Medical College,Guangxi Province from January 2015 to December 2016.They were randomly and equally divided into the control group and observation group.The control group was given the routine nursing and the observation group was given whole course nursing intervention.The delivery mode,pregnancy outcomes and nursing satisfaction between two groups were compared.Results The observation group had higher success rate of vaginal delivery and nursing satisfaction,and lower cesarean rate and bleeding amount(P < 0.05).The rates of delivery aids,postpartum hemorrhage,neonatal asphyxia and uterine rupture had no significant difference(P > 0.05).Conclusion The whole course nursing intervention during delivery can effectively improve the success rate of TOLAC,reduce bleeding amount,and improve nursing satisfaction.
引文
[1]阮焱,张为远.剖宫产的现状及剖宫产率居高不下的原因[J].实用妇产科杂志,2015,31(4):241-243.
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[3]杨慧霞,李博雅.剖宫产后时代面临的挑战剖宫产术后再次妊娠阴道分娩相关问题[J].中华妇产科杂志,2016,51(8):573-575.
[4]罗漫灵,钟梅.剖宫产术后再次阴道分娩预测模型研究进展[J].中国实用妇科与产科杂志,2015,31(1):87-90.
[5]牟田,王雁,刘国莉,等.剖宫产术后经阴道分娩的7种预测模型在中国的临床应用[J].北京大学学报医学版,2016,48(5):795-800.
[6]徐云.剖宫产术后再次妊娠经阴道分娩可行性及安全性临床分析[J].中南医学科学杂志,2016,44(1):91-92,111.
[7]严倩,刘荣慧,王丽娟,等.剖宫产术后再次妊娠阴道分娩的安全性探讨[J].实用妇产科杂志,2016,32(12):933-936.
[8]魏素花,叶晓东,郭梅.129例剖宫产后再次妊娠经阴道分娩产妇的护理[J].护理学报,2016,23(7):64-66.
[9]郑琳.全程连续性助产护理对剖宫产术后阴道分娩妊娠结局及护理满意度的影响[J].中国临床护理,2015,7(5):405-407.
[10]罗漫灵,陈旭菲,于燕,等.剖宫产术后阴道分娩成功的影响因素[J].中华围产医学杂志,2016,19(2):99-103.
[11]张建宏,巩莲芳,张素霞,等.剖宫产术后再次妊娠经阴道分娩的可行性研究[J].解放军医药杂志,2016,28(66):42-44.
[12]陈志芳,吴宏荷,孙晓琴,等.全程连续性助产护理对剖宫产术后阴道分娩产妇产痛程度及产程的影响[J].川北医学院学报,2016,31(5):759-761.
[13]姚玮,左媛,贾黎英,等.不同护理干预方案对剖宫产术等候期产妇焦虑情绪的影响[J].山西医药杂志,2016,45(19):2313-2315.
[14]郝晓丽,侯萍丽,宁国芳,等.瘢痕子宫妊娠阴道分娩的观察与护理体会[J].山西医药杂志,2015(2):232-234.
[15]吕艳,高海莹.剖宫产术后阴道分娩的评估及实施中监测要点[J].天津护理,2016,24(4):373-375.
[16]覃明慧.剖宫产术后再次妊娠经阴道分娩的观察及护理[J].中国临床新医学,2016,9(1):75-78.
[2]Smith D,Stringer E,Vladutiu CJ,et al.Risk of uterine rupture among women attempting vaginal birth after cesarean with an unknown uterine scar[J].Am J Obstet Gynecol,2015,213(1):80.e1-e5.
[3]杨慧霞,李博雅.剖宫产后时代面临的挑战剖宫产术后再次妊娠阴道分娩相关问题[J].中华妇产科杂志,2016,51(8):573-575.
[4]罗漫灵,钟梅.剖宫产术后再次阴道分娩预测模型研究进展[J].中国实用妇科与产科杂志,2015,31(1):87-90.
[5]牟田,王雁,刘国莉,等.剖宫产术后经阴道分娩的7种预测模型在中国的临床应用[J].北京大学学报医学版,2016,48(5):795-800.
[6]徐云.剖宫产术后再次妊娠经阴道分娩可行性及安全性临床分析[J].中南医学科学杂志,2016,44(1):91-92,111.
[7]严倩,刘荣慧,王丽娟,等.剖宫产术后再次妊娠阴道分娩的安全性探讨[J].实用妇产科杂志,2016,32(12):933-936.
[8]魏素花,叶晓东,郭梅.129例剖宫产后再次妊娠经阴道分娩产妇的护理[J].护理学报,2016,23(7):64-66.
[9]郑琳.全程连续性助产护理对剖宫产术后阴道分娩妊娠结局及护理满意度的影响[J].中国临床护理,2015,7(5):405-407.
[10]罗漫灵,陈旭菲,于燕,等.剖宫产术后阴道分娩成功的影响因素[J].中华围产医学杂志,2016,19(2):99-103.
[11]张建宏,巩莲芳,张素霞,等.剖宫产术后再次妊娠经阴道分娩的可行性研究[J].解放军医药杂志,2016,28(66):42-44.
[12]陈志芳,吴宏荷,孙晓琴,等.全程连续性助产护理对剖宫产术后阴道分娩产妇产痛程度及产程的影响[J].川北医学院学报,2016,31(5):759-761.
[13]姚玮,左媛,贾黎英,等.不同护理干预方案对剖宫产术等候期产妇焦虑情绪的影响[J].山西医药杂志,2016,45(19):2313-2315.
[14]郝晓丽,侯萍丽,宁国芳,等.瘢痕子宫妊娠阴道分娩的观察与护理体会[J].山西医药杂志,2015(2):232-234.
[15]吕艳,高海莹.剖宫产术后阴道分娩的评估及实施中监测要点[J].天津护理,2016,24(4):373-375.
[16]覃明慧.剖宫产术后再次妊娠经阴道分娩的观察及护理[J].中国临床新医学,2016,9(1):75-78.