基于助产士门诊的系统管理对初产妇围生期的影响  

Effect of systematic management of midwives clinic on perinatal status of primiparas

作　　者：周立平[1] 潘继红[2] 邹文霞[1] 谭霭谊[1] 姚瑛[2] 冯燕勤 吕凤[1] 

机构地区：[1]广东省妇幼保健院产科,广东广州510010 [2]广东省妇幼保健院护理部,广东广州510010

出　　处：《护理学杂志》2014年第8期23-27,共5页

摘　　要：目的探讨基于助产士门诊系统管理对初产妇会阴损伤、心理健康及母乳喂养的影响。方法选取规律产检、妊娠≤20周的单胎初产妇为研究对象,根据产妇意愿分为对照组(521例)和观察组(289例)。对照组在妊娠各期接受规律产检、营养和体质量管理,定期参加产前教育课程,入院待产、分娩时接受常规护理;观察组除接受以上常规处理外,由助产士对其进行孕期保健知识评估与指导,心理健康状态评估与系统管理,分娩计划制定,妊娠晚期会阴按摩、分阶段促进自然分娩策略和母乳喂养指导,以及产后42d的追踪随防。结果观察组会阴侧切率和会阴伤口疼痛程度显著低于对照组,母乳喂养率显著高于对照组,乳胀率和产后抑郁发生率显著低于对照组(均P<0.01)。结论基于助产士门诊的系统管理有利于提高初产妇围生期身心健康水平,提高母乳喂养率。Objective To study the effect of systematic management of midwives clinic on perineal injury,mental health and breastfeeding behaviors of primiparas.Methods A total of 810 monotocous primiparas who were in early pregnancy （less than 20 weeks） and having regular antenatal check-ups,were divided into a control group of 589 and an observation group of 289based on how they would be involved into the study.The control group joined regularly antenatal check-ups,participated in nutrition and weight control program,and a prenatal education program at all stages of pregnancy; and they received conventional nursing care after they were admitted to the hospital for delivery.Besides routine intervention,the observation group joined a midwife-led systematic management program in which,midwives evaluated the knowledge levels of these pregnant women and gave antenatal guidance,evaluated their mental health,made plans for delivery,provided massage service in late pregnancy,took measures to boost vaginal delivery,gave breastfeeding guidance after delivery,and made postpartum follow-ups 42 days after childbirth.Results The rates of episiotomy,perineal laceration and wound pain degree of the observation group were significantly lower and milder than those of the control group; the rate of breastfeeding in the observation group were significantly higher than in the control group,and meanwhile the rates of breast swelling and postpartum depression in the observation group were significantly lower than those in the control group （P＜ 0.01）.Conclusion The midwife-led systematic management program is beneficial to perinal health of primiparas.

关 键 词：初产妇 助产士门诊 系统管理 会阴损伤 母乳喂养 心理健康 

分 类 号：R473.71[医药卫生—护理学]