目的 探讨母乳喂养门诊全程服务模式对乳头凹陷孕妇母乳喂养率的影响,为临床改善乳头凹陷产妇的母乳喂养成功率提供有效策略.方法 选择2019年11月至2020年10月在本院门诊产检孕期在36w以上存在乳头凹陷的孕妇100例,以自愿选择参加母乳喂养门诊为原则,分为对照组(50例)和试验组(50例).对照组给予常规产检与孕期宣教,内容包括体位、活动、饮食、心理、母乳喂养知识宣教等,试验组在对照组基础上,针对乳头凹陷程度给予一对一指导的母乳喂养门诊全程服务模式.比较两组孕妇分娩后新生儿首次吸吮、院内母乳喂养成功率、42d母乳喂养率.结果 两组患者均完成试验.两组孕妇分娩后新生儿首次吸吮、院内母乳喂养成功率、42d母乳喂养率比较,差异有统计学意义(均P<0.01),试验组各项指标均高于对照组.结论 母乳喂养门诊全程服务模式用于乳头凹陷的孕妇能提高产妇母乳喂养率,可为临床改善乳头凹陷产妇母乳喂养提供一种有效的方法.

目的 探讨以家庭为中心的围产期护理对产妇母婴分娩结局的影响.方法 将2018年1月—2019年12月在医院进行常规产前检查并住院分娩的160例初产妇,按照基础资料组间具有可比性原则,分为对照组和观察组,各80例.对照组产妇采用常规产科护理,观察组产妇在对照组基础上采用以家庭为中心的围产期护理.结果 结果显示,观察组产妇分娩疼痛轻于对照组,差异均有统计学意义(P<0.05).观察组产妇CAQ各维度得分及总得分均低于对照组,差异均有统计学意义(P<0.05).观察组产妇总产程低于对照组,阴道分娩率高于对照组,差异均有统计学意义(P<0.05).结论 以家庭为中心的围产期护理模式,可以降低产妇分娩恐惧程度,缓解产妇分娩痛感,缩短产程时间,提高自然分娩率.

Objective To explore the effect of " behavioral change theory" nursing model on the self_nursing ability of blood glucose related indicators and maternal and infants outcomes in patients with gestational diabetes melli_tus. Methods A total of 168 patients with gestational diabetes diagnosed by obstetrics examination in the hospital from January to December 2016 were selected. They were randomly divided into control group and research group, 84 cases of each group. The pregnant women in the control group received routine nursing intervention, and the pregnant women in the research group received the nursing mode based on the " behavior change theory" on the basis of routine nursing intervention. The blood glucose related indexes and maternal and infant outcomes of each group before and after the in_tervention were statistically analyzed. The self_care behavior of pregnant women before and after intervention was evalua_ted by diabetes self_care behavior assessment scale. Results Before intervention, the blood glucose level of pregnant women in each group was basically consistent with the score of self_care ability assessment, and the difference was sta_tistically significant (P>0. 05) . After different modes of nursing intervention, the level of blood glucose and the ability of self_care related to diabetes were decreased or increased in both groups. In addition, the fasting and postprandial 2 h blood glucose and HbA1c levels in the research group were lower than those in the control group, and the scores of self_care assessment items were higher than those in the control group. The incidence of adverse maternal and infant out_comes such as cesarean section, postpartum hemorrhage, preterm delivery and macrosomia was lower than that of the control group, and the differences were statistically significant ( P<0. 05). Conclusion In the process of blood glu_cose control in patients with gestational diabetes mellitus, the nursing mode based on " behavioral change theory" has a significant effect on intervention, which can control the blood glucose level of pregnant women in a reasonable range, im_prove the ability of self_care of pregnant women, and reduce the incidence of adverse outcomes of maternal and infants. [Key words] Gestational diabetes mellitus; Behavioral change theory; Blood glucose; Self_care; Maternal and child outcomes

目的 探讨不同护理模式运用于高危初产妇中对妊娠结局影响.方法 选择2014年10月至2016年10月无锡市妇幼保健院接收的高危初产妇128例,按随机数字表法分为两组,每组64例.对照组采用常规护理模式,观察组采用连续细致护理模式.观察并记录两组护理前后自我效能评分、妊娠结局和体质量增长情况,并作对比分析.结果 观察组护理后药物治疗、日常生活、遵医行为、健康行为评分均高于对照组,差异有统计学意义(P<0.05);观察组顺产发生率81.25％高于对照组48.44％(χ2=15.113,P<0.001);观察组新生儿Apgar评分(7.65±2.15)分高于对照组的(5.72±3.22)分(t=3.988,P<0.05);观察组剖宫产、钳产发生率和新生儿早产率、体质量异常率均低于对照组,差异有统计学意义(P<0.05);观察组产妇孕期各体质量指数区间体质量增长情况优于对照组,差异有统计学意义(P<0.05).结论 给予高危初产妇连续细致护理干预可有效提升产妇自我效能,改善妊娠结局,降低剖宫产发生率,保障产妇孕期体质量自然增长,值得临床推广.

[目的]探讨助产士心理干预应用于自然分娩对分娩结局及情绪状况的影响.[方法]选取2016年8月 —2017年11月我院收住的96例欲自然分娩待产初产妇为研究对象,随机将其分为研究组和对照组各48例,给予对照组常规护理干预,在此基础上助产士对研究组实施心理干预,比较两组分娩结局 、新生儿窒息 、产后2 h出血量 、各产程时间 、分娩前后焦虑和抑郁状态.[结果]研究组自然分娩率是89.58％,明显高于对照组(60.42％),产钳助产率及中转剖宫产率分别为6.25％ 、4.17％,均明显低于对照组20.83％ 、18.75％(P<0.05);研究组新生儿窒息率是2.08％,明显比对照组(12.50％)更低,且产后2 h出血量低于对照组(P<0.05);研究组第1产程 、第2产程 、第3产程以及总产程时间均明显比对照组短(P<0.05);分娩后,两组焦虑和抑郁评分均显著改善,且研究组焦虑和抑郁评分低于对照组(P<0.01).[结论]在自然分娩常规护理基础上,助产士对产妇进行心理干预可以有效提高产妇自然分娩率,减少产程时间,降低新生儿窒息率,减少产后出血量,缓解产妇负面情绪.

目的 探讨亲情化干预对产妇自我保健能力及对新生儿照护技能的影响.方法 选取入我院分娩产妇42例产妇,在常规护理基础上给予亲情化护理干预.干预前和出院后第8周末观察42例产妇自我保健能力及对新生儿照护技能.结果 产妇出院后第8周末在自我情感调适、不良症状处理、产后饮食自我管理、新生儿照护、产褥期卫生及自我保健能力总分均高于干预前(P<0.05);出院后第8周末,90%(38/42)产妇完成新生儿抚触技术,86%(36/42)产妇完成新生儿母乳喂养.结论 亲情化护理干预有助于提高产妇自我保健能力,改善产妇对新生儿照护技能,值得临床借鉴使用.

Objective To study the influence of precision medicine-based health education on cognitive level of disease knowledge,anxiety and depression in patients with gestational diabetes.Methods Toally 84 cases of gestational diabetes patients in our hospital from September 2014 to December 2015 were divided into a study group and a control group according to the random number table,42 cases in each group.While the routine nursing intervention was done in the control group,the precision medicinebased health education program was carried out in the study group.The two groups were assessed using the cognitive questionnaire designed by our hospital.The self rating anxiety scale (SAS) and self rating depression scale (SDS) prepared by Zung were used to assess the levels of anxiety and depression in the two groups before the intervention and two weeks after the intervention.Results The cognitive level of disease knowledge in the study group after the intervention was statistically significantly higher than that of the control group (P＜0.05).Before the intervention,there were statistically insignificant differences in anxiety and depression between the two groups (P＞0.05),but after the intervention,the levels of anxiety and depression in the study group were significantly lower than those of the control group (P＜0.05).Conclusion The precision medicine-based health education is helpful for the patients with gestational diabetes to improve their diabetes-related knowledge and meanwhile it can relieve their anxiety and depression.

目的 研究家属-产妇交互式情感传达对产妇精神情感状况及分娩相关不良事件的影响.方法 选取该院产科2015年2月至2016年8月收治的84例住院分娩的产妇,以随机数字表将所有纳入对象分为研究组和对照组,每组各42例.其中,对照组实施传统的临床照护,而研究组则在对照组基础上引入家属-产妇交互式情感传达护理模式.2组产妇在干预前及分娩后3 d接受焦虑自评量表(SDS)和抑郁自评量表(SAS)测评;比较2组产妇于分娩后1周内的分娩相关不良事件的发生情况;2组产妇均于分娩后3 d接受护理满意度问卷调查.结果 2组产妇干预前的SAS和SDS评分比较差异无统计学意义(P>0.05);研究组分娩后3 d的SAS和SDS评分均低于对照组,差异有统计学意义(P<0.05).研究组产妇会阴伤口愈合不良、产后出血发生率均低于对照组,差异有统计学意义(P<0.05).研究组护理满意度为97.6%,高于对照组的88.1%,差异有统计学意义(P<0.05).结论 基于家属-产妇交互式情感传达护理模式应用于产妇中,能有效改善其焦虑、抑郁情绪,且能降低分娩相关不良事件,值得推广.

Objective To explore the effect of bi-directional mass feedback model on postoperative recovery,negative emotion and complication in parturient underwent caesarean sectionwith pregnancy induced hypertension.Methods A total of 104 cases of parturient underwent caesarean sectionwith pregnancy induced hypertension of our hospital from September 2014 to September 2016 were collected,they were randomly divided into two groups:the control group (n=52) was given routine nursing,and the observation group (n=52) was given bi-directional mass feedback model.The scores of Self-Rating Anxiety Scale (SAS),self-rating depression scale (SDS) before and after treatment,postoperative recover,and complication were analyzed between the two groups.Results The first exhaust time,first lactation time,first time of leaving bed and spontaneous urination in the observation group were shorter than those in the control group (P＜0.05).After intervention,SAS and SDS scores of two groups were lower compared with those before intervention,and the scores of SAS and SDS in the observation group were lower than those in the control group (P ＜ 0.05).The incidence of complications in the observation group was lower than that in the control group (P ＜ 0.05).Conclusion Bi-directional mass feedback model is effective in the treatment of parturient underwent caesarean section with pregnancy induced hypertension,which can relieve the negative emotion of the patients and reduce the incidence of complications and promote the early recovery.

[目的]探讨“三位一体”护理模式在妊娠期糖尿病病人中的应用效果。[方法]对在我院产科进行产前检查并分娩的50例糖尿病病人采取“三位一体”的无缝护理模式，比较干预前和干预3个月后病人血糖控制情况、治疗依从性和相关知识掌握程度。[结果]干预后，病人血糖控制情况、治疗依从性和相关知识掌握情况均优于干预前(P <0.05)。[结论]“三位一体”护理模式能够有效提高妊娠期糖尿病病人的血糖控制情况和治疗依从性，加强病人的自我护理技能。

目的 探讨强化心理干预应用于妊娠期糖尿病孕妇对其焦虑、抑郁不良情绪及妊娠结局的影响.方法 选择2014年9月～2015年12月期间我院收治的妊娠期糖尿病孕妇98例,将实施强化心理干预护理的49例归为研究组,将实施常规护理的49例为对照组,比较两组孕妇不良情绪和妊娠结局的各项指标.结果 护理前两组孕妇的不良情绪评估及血糖水平,组间无明显差异(P＞0.05);护理干预后两组孕妇的焦虑,抑郁情绪和血糖水平均较护理前明显改善,研究组改善情况明显优于对照组(P＜0.01);研究组孕妇治疗依从性高于对照组(P＜0.01);研究组剖宫产率、产后出血发生率和新生儿窒息发生率低于对照组(P＜0.05).结论 对妊娠期糖尿病孕妇实施强化心理干预能明显改善其焦虑、抑郁的不良情绪,提高治疗依从性,从而更好的控制血糖水平,降低不良妊娠结局的发生.

目的 通过比较一氧化二氮(笑气)吸入镇痛、水中镇痛和瑞芬太尼静脉自控镇痛在初产妇分娩镇痛中的效果,分析不同镇痛方法对母儿的影响.方法 收集在我院选择无痛分娩的单胎足月初产妇105例,随机分为笑气组、水中组和静脉组3组,每组35例,分别采用笑气吸入镇痛、水中镇痛和瑞芬太尼静脉自控镇痛,观察各组的镇痛效果、产程进展、缩宫素使用、分娩方式、产后出血及新生儿窒息情况.结果 3组初产妇总产程、第二产程、产后2h及产后24 h出血量、分娩方式和新生儿Apgar评分比较,差异无显著性(P＞0.05);水中组镇痛效果与静脉组相似,与笑气组相比差异有显著性(Z=-2.859,P＜0.05);水中组缩宫素应用例数明显少于静脉组,差异有显著性(x2=5.280,P＜0.05).结论 水中镇痛可有效缓解产妇的分娩疼痛并减少产程中的干预,对母儿影响较少,是一种安全有效的镇痛方法.

Objective To investigate the effect of dietary and exercise on the incidence of GDM in women with pre-pregnancy obesity. Methods One hundred and sixty early pregnant women with BMI≥25 kg/m2 in our hospital from April 2013 to January 2015 enrolled in the study were divided into two groups: The eighty women hospitalized during June 2013 to January 2014 were assigned as the control group, while the other 80 women from February 2014 to January 2015 as the study group. In the former group, the routine pregnancy inspection and pregnancy health education seminars were conduced during pregnancy of 12 weeks , and in the study group weekly nutritional assessment , diet planning by a dietitian and exercise guidance by a professional nurse were performed apart from the same care as in the control group. The two groups were compared in terms of weight growth and GDM incidence. Result The weight increased and the GDM incidence in the study was both significantly lower than those in the control group ( P < 0 . 05 ) . Conclusion The dietary and exercise during pregnancy can effectively control the weight and decrease the incidence of GDM , which can ensure the health of pregnant women.

随着现代医学的发展轨迹和社会发展趋势,护理模式已由功能制护理转向系统化整体护理,护理工作内容已从对病人的护理扩展到对健康的维护和促进.