产前胎心监护无应激试验阴性护理干预的临床研究  

Clinical study of nursing intervention for negative results of non-stress test in prenatal fetal heart monitoring

作　　者：张婷[1] 张宏玉[2] 符红珊 

机构地区：[1]海口市妇幼保健院国兴妇科门诊,海南海口570203 [2]海南医学院,海南海口571119

出　　处：《海南医学》2015年第6期928-930,共3页Hainan Medical Journal

基　　金：海南省卫生厅科研立项(编号:琼卫2012 LX-26)

摘　　要：目的寻求一种有效改善产前胎心监护无应激试验（Non-strees test,NST）阴性的安全简便干预方法,确定吸氧时的呼吸方式。方法将2013年1月至2014年4月在海口市妇幼保健院门诊行产前NST,孕34周及以上,初次NST评分为6～7分且胎儿脐动脉血流S/D值正常的单胎低危孕妇450例按随机数字表法分腹式深呼吸吸氧（A）组、正常呼吸吸氧（B）组和腹式深呼吸（C）组各150例,分别在复查NST时采用腹式深呼吸吸氧、正常呼吸吸氧和腹式深呼吸。比较再次复查NST时胎心率变异、胎动时胎心率加速的阳性反应。结果 24 h内复查NST,三种方法干预后比干预前NST评分均有提高,B组评分改变最低,分别与其他组比较差异有统计学意义（P〈0.05）;24 h复查NST仍为阴性的A组最低,分别与其他两组比较差异有统计学意义（P〈0.05）,其他两组间比较差异无统计学意义（P〉0.05）;行急诊剖宫产术5例,B组2例和C组3例,新生儿出生阿氏评分均10分,存活,三组间急诊剖宫产率比较差异无统计学意义（P〉0.05）。结论采用腹式深呼吸吸氧有利于改善NST阴性,降低假阴性反应率,减少医疗干预,提高产科护理质量。Objective To explore a safe and simple method for improve negative results of non-stress test（NST） in prenatal fetal heart monitoring. Methods A total of 450 pregnant women received NST（over 34 weeks of pregnancy, scored 6～7 in initial NST and with normal S/D value） in Department of Gynecology in Haikou Maternal and Child Health Hospital from January, 2013 to April, 2014 were enrolled. The women were randomly arranged to three groups： group A, group B and group C, with 150 cases in each group, which applied deep abdominal breath plus oxygen therapy, normal breath plus oxygen therapy, and deep abdominal breath in the second NST, respectively. Fetal heart rate and NST results were checked 24 hours later. Results After 24 hours, all the three groups had increased value of the NST score, and the improvement in group B was the lowest, showing statistically significant difference with that in group A and group C. The rate of negative results of NST in group A 24 hours later was the lowest, showing statistically significant difference with the other groups（P〈0.05）, but there was no significant difference between group B and group C. Two women in group B and 3 women in group C had caesarean section. All the 5 babies were alive and had Apgar score of 10. The emergence cesarean section rate showed no significant difference among the three groups（P〉0.05）. Conclusion Deep abdominal breath plus oxygen therapy can improve the NST results, decrease false negative rate, reduce medical intervention and improve nursing quality.

关 键 词：产前胎心监护 无应激试验 假阴性率 腹式深呼吸 吸氧 

分 类 号：R473.71[医药卫生—护理学]