多学科团队协作诊疗模式下延续护理在妊娠期心脏病患者产后应用中的疗效观察  

Observation on the effect of postpartum application of extended care in patients with heart disease during pregnancy under the mode of multi-disciplinary team collaboration

作　　者：齐慧[1] 刘慧杰 王宏敏 王平凡[1] 王志敏[1] Qi Hui;Liu Huijie;Wang Hongmin;Wang Pingfan;Wang Zhimin(Department of Obstetrics,the Second People's Hospital of Liaocheng,Liaocheng 252600,Shandong,China)

机构地区：[1]聊城市第二人民医院产科,山东聊城252600

出　　处：《中国中西医结合急救杂志》2024年第1期77-81,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：山东省中医药科技发展计划项目(2019-0912)。

摘　　要：目的分析多学科协作诊疗(MDT)模式下延续护理在妊娠期心脏病患者产后应用中的效果。方法选择聊城市第二人民医院2020年6月至2022年6月收治的116例妊娠期心脏病患者作为研究对象,将患者按护理模式分为观察组和对照组,每组58例。所有患者均于本院完成分娩,对照组产后给予常规临床干预;观察组给予MDT模式下的延续护理干预,包括组建团队、实施干预、心理护理,首先建立管理团队并组建微信群,成员包括1名产科副主任医师、1名心内科副主任医师、1名营养师、1名心理治疗师、1名产科护士长、1名心内科护士长、3名产科责任护士、3名心内科责任护士;然后分产前、产中、产后3个阶段分别进行护理干预;最后在院内和随访中通过与患者沟通了解其基本情况,给予针对性疏导,指导其转移对负性情绪的注意力。两组均干预6个月。采用健康行为能力自评量表(SRAHP)评价患者的健康行为能力(包括营养状况、运动、健康责任、心理安适),采用心房颤动患者生活质量量表(AF-QoL-18)评分评价患者的生活质量(包括生理、心理、性功能)并观察两组患者宫颈局部微循环(包括血流灌注、毛细血管管径、微血管管径)、产后2h和24h出血量、产后住院时间、母婴不良结局(包括产后出血、心力衰竭、孕妇死亡、新生儿死亡)。结果两组干预后各项SRAHP评分和AF-QoL-18评分及宫颈局部微循环水平均较干预前明显提高,且干预后观察组上述指标均明显高于对照组[营养状况评分(分):25.06±2.31比19.72±2.68,运动能力评分(分):25.54±1.45比19.14±3.65,健康责任评分(分):24.17±2.33比20.54±2.52,心理安适评分(分):25.03±1.62比21.34±3.35,血流灌注(mL/min):1.10±0.18比0.44±0.15,毛细血管管径(μm):5.94±0.45比3.41±0.67,微血管管径(μm):56.59±2.13比44.12±3.78,生理评分(分):3.86±1.13比3.41±1.04,心理评分(分):4.13±0.64比3.67±1.42Objective To analyze the effect of extended care in patients with gestational heart disease under the mode of multi-disciplinary team(MDT).Methods A total of 116 patients with gestational heart disease admitted to Liaocheng Second People's Hospital from June 2020 to June 2022 were selected as the study objects,and the patients were divided into observation group and control group according to nursing method,with 58 patients in each group.All the patients delivered in our hospital,and the control group received routine clinical intervention after delivery.The observation group was given continuous nursing intervention under MDT mode,including team building,intervention implementation and psychological nursing.First,a management team was established and a WeChat group was formed.The team members include 1 deputy chief physician of obstetrics,1 deputy chief physician of cardiology,1 dietitian,I psychotherapist,1 head nurse of obstetrics,1 head nurse of cardiology,3 responsible nurses of obstetrics and 3 responsible nurses of cardiology.Then the nursing intervention was divided into 3 stages:prenatal,postpartum,and postpartum.Finally,in the hospital and during the follow-up,we communicated with the patients to understand their basic situation,provided targeted guidance,and directed them to shift their attention from negative emotions.Both groups were treated for 6 months.The self-rated abilities for health practices scale(SRAHP)was used to evaluate the patient's health behavior ability(including nutrition status,exercise,health responsibility,and psychological well-being),and atrial fibrillation-quality of life-18(AF-QoL-18)was used to evaluate the patient's quality of life(including physiological,psychological,and sexual function).Cervical local microcirculation(including blood perfusion,capillary tube diameter,microvascular tube diameter),postpartum blood loss at 2 hours and 24 hours,postpartum hospital stay,maternal and infant adverse outcomes(including postpartum hemorrhage,heart failure,maternal death,neonatal d

关 键 词：妊娠期 心脏病 产后 多学科团队协作诊疗 延续护理 

分 类 号：R714.25[医药卫生—妇产科学]