标题：助产护理干预对高龄产妇分娩方式及产程的影响

      作者：桂冰，卢锦芳，朱惠娟    (南方医科大学附属小榄医院妇产科，广东 中山 528415)

      卷次： 2018年29卷17期

      【摘要】 目的 探讨助产护理干预对高龄产妇分娩方式及产程的影响。方法 选择2015年1月至2017年6月期间在南方医科大学附属小榄医院妇产科住院分娩的200例高龄产妇为研究对象，根据随机数表法分为对照组和观察组，每组100例，对照组予产科常规护理，观察组给予助产综合护理干预，比较两组产妇的分娩方式、产程时间与产后出血情况；分娩前后采用汉密尔顿焦虑自评量表(HAMA)、汉密尔顿抑郁量自评表(HAMD)进行评分，以评价产妇的焦虑、抑郁情绪。结果 观察组产妇的第一产程、第二产程、第三产程和总产程分别为(485.2±75.2) min、(41.1±7.6) min、(5.7±2.1) min、(537.6±102.2) min，均明显短于对照组的(510.2±87.3) min、(44.2±9.4) min、(6.9±2.5) min、(567.4±111.3) min，差异均有统计学意义(P<0.05)；观察组产妇的剖宫产率为25.0%，明显低于对照组的38.0%，差异有统计学意义(P<0.05)；观察组产妇产后2 h出血量为(212.3±30.9) mL，明显少于对照组的(241.6±34.3) mL，差异有统计学意义(P<0.05)；观察组分娩前及分娩后HAMA、HAMD评分分别为(16.1±2.5)分、(16.2±3.8)分和(12.0±2.4)分、(11.8±2.4)分，均明显低于对照组的(18.5±3.1)分、(19.7±4.5)分和(16.8±2.9)分、(14.9±3.6)分，差异有统计学意义(P<0.05)。结论 助产护理干预可以缩短高龄产妇的产程时间，降低剖宫产率，减少产后出血量，缓解产妇的负面情绪。
      【关键词】 高龄产妇；助产护理；剖宫产；产程；焦虑；抑郁
      【中图分类号】 R473.71 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2512—03

Effect of midwifery nursing intervention on the delivery mode and labor of the elderly parturient.
GUI Bing, LUJin-fang, ZHU Hui-juan. Department of Gynaecology and Obstetrics, Xiaolan Hospital Affiliated to Southern MedicalUniversity, Zhongshan 528415, Guangdong, CHINA
【Abstract】 Objective To explore the effect of midwifery nursing intervention on the delivery mode and laborof the elderly parturient. Methods A total of 200 cases of elderly puerpera, who admitted to Department of Gynaecolo-gy and Obstetrics of Xiaolan Hospital Affiliated to Southern Medical University from January 2015 to June 2017, wereselected and divided into the observation and the control group according to random number method, with 100 cases ineach group. The control group received routine obstetric care, and the observation group received additionally midwiferynursing intervention. The mode of delivery, delivery time and postpartum hemorrhage of the two groups were comparedbefore and after the delivery. The Hamilton Anxiety Rating Scale (HAMA) and Hamilton Rating Scale for Depression(HAMD) were used to evaluate the anxiety and depression of the parturient. Results The first, second, third stage of la-bor and total labor in the observation group were (485.2±75.2) min, (41.1±7.6) min, (5.7±2.1) min, (537.6±102.2) min,respectively, which were significantly shorter than corresponding (510.2 ± 87.3) min, (44.2 ± 9.4) min, (6.9 ± 2.5) min,(567.4±111.3) min in the control group (P<0.05); the cesarean section rate of the observation group was 25.0%, whichwas significantly lower than 38.0% of the control group (P<0.05); the postpartum 2 h hemorrhage in the observation groupwas (212.3±30.9) mL, which was significantly less than (241.6±34.3) mL in the control group (P<0.05); the HAMA andHAMD scores before and after the delivery in the observation group were (16.1±2.5) points, (16.2±3.8) points and (12.0±2.4) points, (11.8±2.4) points, respectively, which were significantly lower than (18.5±3.1) points, (19.7±4.5) points and(16.8±2.9) points, (14.9±3.6) points in the control group (P<0.05). Conclusion Midwifery nursing intervention can short-en the duration of labor, reduce the rate of caesarean section and reduce the amount of postpartum hemorrhage, and easematernal negative emotions.
      【Key words】 Elderly parturient women; Midwifery nursing; Cesarean section; Production process; Anxiety; De-pression·护 理·doi:10.3969/j.issn.1003-6350.2018.17.044