助产士门诊干预对经产妇妊娠与分娩的影响  

Effect of midwife outpatient intervention on multipara pregnancy and delivery

作　　者：孙英[1] 张庆金[1] 潘培芳[2] 陈卫 SUN Ying;ZHANG Qingjin;PAN Peifang;CHEN Wei(Medical Department of Guangxi University of Science and Technology,Liuzhou,Guangxi 545006,China;Department of Obstetrics,First Affiliated Hospital,Guangxi University of Science and Technology,Liuzhou,Guangxi 545002,China;Department of Obstetrics,Second Affiliated Hospital,Guangxi University of Science and Technology,Liuzhou,Guangxi 545005,China)

机构地区：[1]广西科技大学医学部,广西柳州545006 [2]广西科技大学第一附属医院产科,广西柳州545002 [3]广西科技大学第二附属医院产科,广西柳州545005

出　　处：《现代医药卫生》2020年第2期184-187,共4页Journal of Modern Medicine & Health

基　　金：广西高校中青年教师基础能力提升项目(2017KY0335);广西高等教育本科教学改革工程项目(2017JGB298)

摘　　要：目的探讨助产士门诊服务对经产妇妊娠并发症与分娩结局的影响。方法选取2017年1月至2018年9月在广西科技大学第一附属医院或广西科技大学第二附属医院建卡并要求在广西科技大学第一附属医院或广西科技大学第二附属医院孕期检查分娩的经产妇490例,将自愿接受助产士门诊护理和个性化系统管理的258例设为观察组,其余232例设为对照组。比较2组经产妇妊娠期并发症和分娩结局的差异。结果观察组孕妇的孕期体重指数增长率、妊娠期糖尿病发生率、妊娠期高血压发生率、产后出血发生率、会阴侧切率、剖宫产率、新生儿体重、产妇焦虑自评量表评分、抑郁自评量表评分均明显低于对照组,差异均有统计学意义(P<0.05);2组经产妇自然分娩3个产程时长、新生儿肩难产及新生儿窒息发生率比较,差异均无统计学意义(P>0.05)。结论助产士门诊个性化管理干预经产妇孕期体重指数和精神心理明显得到改善,降低了妊娠期并发症发生率,促进了自然分娩,降低了剖宫产率、会阴侧切率和经产妇焦虑抑郁程度,改善了经产妇妊娠和分娩结局。Objective To explore the effect of midwife outpatient service on multipara pregnancy complications and delivery outcomes.Methods A total of 490 multiparas,who established the cards in the First or Second Affiliated Hospital of Guangxi University of Science and Technology and demanded the pregnant examination and delivered in the First or Second Affiliated Hospital of Guangxi University of Science and Technology,were selected.Among them,258 cases voluntarily receiving midwife outpatients nursing and personalized systematic management were set as the observation group,and other 232 cases as the control group.The differences in pregnant complications and delivery outcomes were compared between the two groups.Results The growth rate of body mass index during pregnancy,occurrence rates of gestational diabetes mellitus and pregnancy-induced hypertension,postpartum hemorrhage rate,perineal lateral episiotomy rate,cesarean section rate,neonatal body weight,the SAS score and SDS scores in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The duration of three labor processes,occurrence rates of neonatal shoulder dystocia and neonatal asphyxia and neonatal Apgar score had no statistical differences between the two groups(P>0.05).Conclusion The midwife outpatient individualized management intervention significantly improves the pregnant body weight index and psycology of multiparas,reduces the occurrence rate of pregnant complications,promotes the natural delivery,reduces the cesarean section rate,perineal lateral episiotomy rate and degrees of anxiety and depression,and improve the pregnancy and delivery outcomes of multiparas.

关 键 词：助产士 门诊医疗 妊娠并发症 分娩 经产妇 

分 类 号：R714.7[医药卫生—妇产科学]