实施袋鼠式护理对产妇泌乳、子宫复旧及新生儿疼痛的影响研究  

Effect of kangaroo mother care on lactation,uterine involution and neonatal pain

作　　者：郭路[1] 叶朝[1] 张菁[1] 穆莉萍[1] 冯玉华[1] 刘莹[1] 阎淑君[1] Guo Lu;Ye Zhao;Zhan Jing;Mu Liping;Feng Yuhua;Liu Ying;Yan Shujun(Department of Obstetrics,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院产科,300192

出　　处：《中国实用护理杂志》2020年第18期1383-1388,共6页Chinese Journal of Practical Nursing

摘　　要：目的:探讨实施袋鼠式护理(KMC)对产妇泌乳、子宫复旧及新生儿疼痛的影响。方法:选取2019年1—6月在产科足月顺娩的产妇及新生儿共200对作为研究对象,采用随机数字表法分为对照组、观察组各100对。对照组实施产后护理常规,观察组实施KMC。比较2组产妇对KMC认知情况、产后泌乳及子宫复旧情况、新生儿足跟血采集中的疼痛情况。结果:观察组产妇对KMC的认知明显优于对照组,差异有统计学意义(χ^2值为24.700,P<0.01);观察组首次泌乳时间为产后(41.25±3.20)h,早于对照组(54.17±2.20)h,差异有统计学意义(t值为2.378,P=0.019);观察组产后72 h乳房Ⅰ度(20人)、Ⅱ度(56人)、Ⅲ度(24人)胀痛情况轻于对照组(分别为62、27、11人),差异有统计学意义(t值为12.166,P=0.011);观察组产后48 h泌乳充足者73人明显多于对照组34人,差异有统计学意义(χ^2值为30.570,P=0.000);观察组产后24、48 h子宫底分别下降(3.06±1.26)、(1.67±0.43)cm,均优于对照组(1.97±0.92)、(1.23±0.18)cm,差异有统计学意义(t值为3.162,P=0.002;t值为2.689,P=0.009);新生儿足跟血采集中,观察组采血时和采血后疼痛评分分别为(4.92±0.33)分和(2.37±1.27)分,均低于对照组(5.57±1.37)分和(5.01±1.09)分,差异均有统计学意义(t值为2.035,P=0.046;t值为2.579,P=0.011);观察组采血时和采血后心率分别为(121.36±22.13)、(142.55±23.91)次/min,均低于对照组(152.64±18.21)、(156.79±17.37)次/min,差异均有统计学意义(t值为2.375,P=0.018;t值为2.126,P=0.037);观察组采血时和采血后血氧饱和度分别为0.9672±0.0137和0.9855±0.0224,明显高于对照组0.8917±0.1165和0.9145±0.1378,差异均有统计学意义(t值为2.036,P=0.046;t值为2.017,P=0.047)。结论:实施KMC能够显著促进产妇乳汁分泌、加快子宫复旧、减轻新生儿足跟血采集时的疼痛;加强KMC的健康教育,能提高产妇及其家属对KMC的认知,在促进母婴健康方面有积极意义,值�Objective To explore the effect of kangaroo mother care(KMC)on lactation,uterine involution of parturients and neonatal pain.Methods A total of 200 parturients who gave birth at full term in our hospital from January 2019 to June 2019 and their newborns were selected as the research objects,they were randomly divided into control group and observation group of 100 pairs each.The control group received routine obstetric postpartum care and the observation group received KMC.The KMC cognition,postpartum lactation and uterine involution,neonatal pain during neonatal heel blood collection were compared between the two groups.Results The cognition of KMC in the observation group was significantly better than that in the control group,and the difference was statistically significant(χ^2 value was 24.700,P<0.01).The first lactation time of parturients in the observation group was(41.25±3.20)hours after birth,which was earlier than(54.17±2.20)hours in the control group,there was significant difference between the two groups(t value was 2.378,P value was 0.019).The breast painⅠdegree(20 cases),Ⅱdegree(56 cases),Ⅲdegree(24 cases)in observation group were significantly lighter than those in control group(62,27,11 cases respectively)72h after delivery,the differences were statistically significant(t value was 12.166,P value was 0.011).The parturients of sufficient lactation in the observation group(73 cases)were more than those in the control group(34 case),the differences was statistically significant(χ^2 value was 30.570,P value was 0.000).The uterine fundus of the observation group decreased by(3.06±1.26)cm and(1.67±0.43)cm at 24h and 48h postnatally,which were better than those of the control group(1.97±0.92)cm and(1.23±0.18)cm,the differences were statistically significant(t value was 3.162,P value was 0.002;t value was 2.689,P value was 0.009).In the process of heel blood collection after 72h of delivery in both groups,the pain scores of the observation group during and after blood collection were 4.92±0

关 键 词：袋鼠式护理 产妇泌乳 子宫复旧 新生儿疼痛 

分 类 号：R473.71[医药卫生—护理学]