妇产科急诊中出血性休克的抢救及干预措施  

Rescue and intervention measures of hemorrhagic shock in emergency treatment of obstetrics and gynecology department

作　　者：洪云 朱瑜[1] 李娟[1] 姜红玉 张海波 徐丽丽 陶美霞[2] HONG Yun;ZHU Yu;LI Juan(Department of Emergency,Affiliated Maternal and Child Health Care Hospital of Nantong University,Jiangsu,Nantong 226001,China)

机构地区：[1]南通大学附属南通妇幼保健院急诊室,江苏省南通市226001 [2]南通大学附属南通妇幼保健院护理部,江苏省南通市226001

出　　处：《河北医药》2024年第24期3837-3840,共4页Hebei Medical Journal

基　　金：南通大学临床医学专项科研基金项目(编号:2023HY004)。

摘　　要：目的探究妇产科急诊中出血性休克的抢救及干预措施。方法选取南通大学附属南通妇幼保健院妇产科住院的68例出血性休克患者为研究对象,用随机表法分为2组,对照组34例、观察组34例。对照组采用传统的抢救和护理,观察组采用综合护理。比较2组止血时间、住院时间、血流动力学、凝血功能、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、不良结局发生情况及抢救效果、护理满意度。结果护理后,观察组止血时间、住院时间少于对照组(P<0.05)。观察组心率(HR)低于对照组,红细胞比容(HCT)、动脉压(MAP)、中心静脉压(CVP)高于对照组(P<0.05)。观察组部分活化凝血活酶时间、血浆凝血酶原时间、凝血酶时间均低于对照组(P<0.05)。观察组SAS评分、SDS评分均低于对照组(P<0.05)。观察组不良结局发生率低于对照组,抢救成功率高于对照组(P<0.05);观察组护理满意度高于对照组(P<0.05)。结论对产科急诊失血性休克患者及时抢救和有效综合护理,能提高抢救效率,减少止血时间、住院时间、抑制血流动力学及凝血功能、改善负性情绪、促进患者恢复,提高满意度,具有较高的临床应用价值,值得推广应用。Objective To explore the rescue and intervention measures of hemorrhagic shock(HS)in emergency treatment of obstetrics and gynecology department.Methods Sixty-eight HS patients in Department of Obstetrics and Gynecology,Affiliated Maternity and Child Health Care Hospital of Nantong University were recruited,they were randomly divided into control group(n=34,traditional rescue and nursing)and observation group(n=34,comprehensive nursing).Hemostasis time,hospital stay,hemodynamics,coagulation function,Self-rating anxiety/depression scale(SAS/SDS)scores,adverse outcome,rescue success rate and nursing satisfaction were compared between the two groups.Results After nursing,the hemostasis time,hospital stay in observation group were significantly shorter than those of control group(P<0.05).Significantly lower heart rate(HR),and significantly higher hematocrit(HCT),mean arterial pressure(MAP),central venous pressure(CVP)were detected in observation group than those of the control group(P<0.05).The activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)in observation group were significantly lower than those in control group(P<0.05).The SAS scores and SDS scores of the observation group were significantly lower than those of the control group(P<0.05).The incidence of adverse outcome in the observation group was significantly lower than that of control group,and the success rate of rescue in the observation group was significantly higher than that in control group(P<0.05).The nursing satisfaction in the observation group was significantly higher than that of control group(P<0.05).Conclusion Timely rescue and efficient comprehensive nursing for HS patients in obstetric emergency can improve rescue efficiency,reduce hemostasis time,hospital stay,inhibit hemodynamics and coagulation function,improve negative emotions,promote patient recovery,and increase satisfaction,which has high clinical application value and is worth popularizing.

关 键 词：妇产科 急诊 出血性休克 抢救 干预 血流动力学 

分 类 号：R714.463[医药卫生—妇产科学]