基于ERAS理念下产后乳胀护理方案对母婴分离产妇心理及泌乳的影响  

Effects of postpartum breast engorgement nursing program under the concept of enhanced recovery after surgery on the psychology and lactation of parturients separated from their infants

作　　者：徐芝灵[1] 孙冬冬[1] 邵春梅[1] 齐慧[1] 蔡英晓 庞海燕[1] 杨阳[1] XU Zhi-ling;SUN Dong-dong;SHAO Chun-mei;QI Hui;CAI Ying-xiao;PANG Hai-yan;YANG Yang(Department of Obstetrics and Gynecology,Shangqiu First People's Hospital,Shangqiu 476100,Henan,CHINA)

机构地区：[1]商丘市第一人民医院产科,河南商丘476100

出　　处：《海南医学》2024年第16期2420-2424,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20221057)。

摘　　要：目的探究加速康复外科医学(ERAS)理念引导下的产后乳胀护理方案对母婴分离的产妇泌乳及心理的影响。方法选取2022年8月至2023年8月于商丘市第一人民医院分娩且母婴分离的160例产妇作为研究对象,采用随机数表法分为对照组和观察组各80例。对照组产妇实施常规产后乳胀护理方案,观察组产妇采取ERAS理念引导下的产后乳胀护理方案,两组产妇均接受1周的护理干预。比较两组产妇干预1周后的泌乳时间、泌乳量、乳房肿胀程度;采用视觉模拟评分法(VAS评估两组产妇干预前、干预3 d、干预1周后乳房的胀痛严重程度;并比较两组产妇干预前、干预1周后的心理状况评分[状态-特质焦虑量表(STA-I)和爱丁堡产后抑郁量表评分(EPDS)]和健康状况调查问卷(SF-36)评分;采用Spearman相关分析法分析乳房肿胀程度与心理状态的相关性。结果观察组产妇的泌乳时间为(30.22±5.81)h、明显早于对照组的(46.38±7.59)h,泌乳量、Ⅰ级乳房肿胀程度占比分别为(469.51±22.31)mL、50.00%,明显多(高)于对照组的(337.81±33.17)mL、31.25%,差异均有统计学意义(P<0.05);干预3 d和1周后,观察组产妇的VAS评分分别为(3.04±0.99)分、(1.05±0.38)分、明显低于对照组的(4.33±1.02)分、(2.82±0.85)分,差异均有统计学意义(P<0.05);干预1周后,观察组产妇的STA-I、EPDS评分分别为(30.25±3.05)分、(3.76±1.05)分,明显低于对照组的(38.11±3.78)分、(6.89±1.83)分,SF-36评分为(88.51±4.38)分,明显高于对照组的(78.36±4.25)分,差异均有统计学意义(P<0.05);经Spearman相关分析结果显示,产妇乳房肿胀程度与STA-I和EPDS评分均呈正相关(r=0.160、0.234,P<0.05)。结论ERAS理念护理方案可改善母婴分离产妇的泌乳异常、胀痛,减轻焦虑抑郁,提升生活质量。Objective To explore the effects of postpartum breast engorgement nursing program guided by the concept of enhanced recovery after surgery(ERAS)on the lactation and psychology of parturients separated from their infants.Methods A total of 160 women who gave birth and were separated from their infants in Shangqiu First People's Hospital from August 2022 to August 2023 were selected as the research subjects.They were divided into a control group(n=80)and an observation group(n=80)by random number table method.The parturients in the control group received routine postpartum breast engorgement nursing,while those in the observation group received ERAS concept-guided postpartum breast engorgement nursing,all for 1 week.The lactation time,lactation volume,and breast swelling degree were compared between the two groups after 1 week of intervention.Visual Analogue Scale(VAS)was used to evaluate the severity of breast swelling and pain before intervention,after 3 d of intervention,and after one week of intervention.The psychological status scores(State-Trait Anxiety Inventory,STAI;Edinburgh Postnatal Depression Scale,EPDS)and 36-Item Short Form Health Survey(SF-36)scores were compared between the two groups of parturients before and after one week intervention.Spearman correlation analysis was used to analyze the correlation between breast swelling degree and psychological state.Results The lactation time in the observation group was(30.22±5.81)h,which was significantly earlier than(46.38±7.59)h in the control group;the proportion of lactation volume and gradeⅠbreast swelling were(469.51±22.31)mL and 50.00%,significantly higher than(337.81±33.17)mL and 31.25%in the control group;the differences were statistically significant(P<0.05).After 3 days and 1 week of intervention,the VAS scores in the observation group were(3.04±0.99)points and(1.05±0.38)points,which were significantly lower than(4.33±1.02)points and(2.82±0.85)points in the control group(P<0.05).After 1 week of intervention,the scores of STAI and EPDS i

关 键 词：加速康复外科医学理念 母婴分离 泌乳 心理 生活质量 

分 类 号：R473.71[医药卫生—护理学]