乙型肝炎初产妇实施综合护理干预的效果分析

任巧靖

[摘要] 目的 探討综合护理干预应用于乙型肝炎初产妇的效果。 方法 选择2015年1月～2017年6在我院分娩的乙型肝炎初产妇120例为研究对象。随机分为干预组与对照组各60例。对照组给予常规产前、产时护理，干预给予综合护理干预。比较两组分娩结局、孕产妇焦虑评分、分娩时VAS评分、分娩应对评分、入组时及分娩前HBV-DNA>1000 copies/mL比例、产妇体重超标率、新生儿HBV标记物阳性率。 结果 分娩前干预组HBV-DNA>1000 copies/mL比例显著低于对照组，差异有统计学意义（P<0.05）。分娩前对照组焦虑评分显著高于干预组，差异有统计学意义（P<0.05）。干预组新生儿体重≥4 kg率、剖宫产率、会阴侧切率、产后2 h出血量显著低于对照组，差异有统计学意义（P<0.05）。干预组产妇体重超标率、VAS评分显著低于对照组，应对能力评分显著高于对照组，差异有统计学意义（P<0.05）。 结论 综合护理干预能够显著改善乙型肝炎初产妇焦虑情况、改善分娩应对情况、降低剖宫产率及会阴侧切率，改善分娩结局。

[关键词] 综合护理干预；乙型肝炎；初产妇；分娩结局

[中图分类号] R473.71 [文献标识码] B [文章编号] 1673-9701（2017）33-0145-04

[Abstract] Objective To explore the effect of comprehensive nursing intervention on primiparas with hepatitis B. Methods 120 hepatitis B primiparas from January 2015 to June 2017 delivered in our hospital were selected and randomly divided into intervention group（n=60）and control group （n=60）. The control group was given routine antenatal and intrapartum care. The intervention group was given comprehensive nursing intervention. The outcome of delivery， maternal anxiety score， VAS score at delivery， childbirth coping score， the rate of HBV-DNA>1000 copies/mL at the time of enrollment and before delivery， the maternal weight exceeded rate and the positive rate of neonatal HBV markers were compared between the two groups. Results The percentage of HBV-DNA> 1000 copies/mL in the intervention group was significantly lower than that in the control group before delivery（P<0.05）. The anxiety score of the control group before delivery was significantly higher than that of the intervention group， and the difference was statistically significant（P<0.05）. The rate of neonatal weight≥4 kg， cesarean section rate， lateral perineal cut rate and postpartum 2h bleeding were significantly lower than those of control group， and the differences were statistically significant（P<0.05）. The maternal weight exceeded rate and VAS score in the intervention group were significantly lower than those in the control group， and the score of coping ability in the intervention group was significantly higher than that of the control group， and the difference was statistically significant（P<0.05）. Conclusion Comprehensive nursing intervention can significantly improve the situation of anxiety and the coping situation of childbirth in hepatitis B primiparas， which reduces cesarean section rate and lateral perineal cut rate and improves the outcome of delivery.

[Key words] Comprehensive nursing intervention；Hepatitis B；Primipara；Delivery outcomeendprint