瘢痕子宫孕妇行羊膜腔灌注治疗的护理  

Caring the Pregnant Women with Cicatricle Uterus Treated with Amnioinfusion

作　　者：黄志红[1] 曾艳华[1] 陆佩华[1] 陈勉予[1] 张玉洁[1] 

机构地区：[1]广州市第一人民医院妇产科,广东广州510180

出　　处：《护理学报》2007年第12期44-45,共2页Journal of Nursing（China）

摘　　要：总结报道481例瘢痕子宫孕妇经腹行羊膜腔灌注治疗的护理体会。做好术前评估,若子宫壁有手术史时间未超过2年则不宜行羊膜腔内灌注术;注意观察有无子宫下段压痛或腹痛不适;术前告知手术可能发生的并发症,取得孕妇及其家属的知情同意;嘱咐孕妇于穿刺前1h适量进食,防止在饥饿状态下操作因胎动频繁穿刺针误伤胎儿。术中严格控制输注速度,以不超2～3 ml/min为宜;严密监测孕妇的血压、脉搏、呼吸及胎心率,尤其注意观察子宫形态及下段有无压痛,监测胎心率及宫缩情况。术后密切观察孕妇生命体征的变化,尤其是体温变化,警惕感染;严密观察有无腹痛、子宫下段压痛、阴道流血或流液等发生,观察有无子宫先兆破裂的重要体征,尤须重视孕妇腹痛的主诉;重点观察和预防胎膜早破、早产、子宫破裂等并发症的发生。本组48例瘢痕子宫孕妇在超声引导下行羊膜腔内灌注,仅1例发生胎膜早破,其余均无早产、死胎、胎膜早破、子宫破裂及胎盘早剥等并发症发生,说明在超声引导下谨慎实施瘢痕子宫羊膜腔内灌注术是安全有效的。The authors reported their experience in caring 481 pregnant women with cicatricle uterus treated with amnioinfusion, arguing the care strategies included preoperative assessment to decide whether to undergo amnioinfusion or not based on their less than two-year history of operation on uterine wall, observing if there was press pain on uterus, preoperative letting them know about possible complications to get their family＇s agreement, proper dieting 1 hour before puncturing to prevent injuring the fetus by mistake, rigid control of transfusion speed and close observation of blood pressure, pulse, respiration and fetus heart rate during operation, and close observation of their vital signs, especially their body temperature, close observation of abdominal pain and press pain at lower uterus, bleeding and fluid flowing in vagina, observation of vital symptoms of portent uterus rupture and prevention of premature rupture of membrane, premature birth, and rupture of uterus after amnioinfusion. Amnioinfusion was conducted among 48 pregnant women with cicatricle uterus. Only one processed with premature rupture of membrane and there were no premature birth, uterus rupture and placental abruption. It indicates that cicatricle uterus treated with amnioinfusion under ultrasonic B direction is safe and effective.

关 键 词：瘢痕子宫 羊膜腔灌注术 观察 护理 

分 类 号：R473.71[医药卫生—护理学]