Nursing effect of incentive health education combined with traditional Chinese medicine suitable technology in patients undergoing cesarean section
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摘要:
目的 将激励式健康教育联合中医适宜技术应用于剖宫产术产妇中，探讨护理效果。 方法 选取2019年1月—2021年12月浙江省丽水市中医院产检的150例剖宫产孕妇，根据临床护理开展时间段分为对照组(60例，2019年1月—2020年6月开展激励式健康教育)和观察组(90例，2020年7月—2021年12月开展激励式健康教育联合中医适宜技术)。比较2组分娩结局、康复情况、疼痛情况、情绪管理、母婴并发症发生情况。 结果 2组产后2 h出血量比较差异无统计学意义(P>0.05)，观察组术后排气时间短于对照组[(1.92±0.64)d vs. (2.93±0.80)d]，而新生儿Apgar评分高于对照组[(9.03±1.69)分vs. (7.75±1.70)分]，差异均有统计学意义(均P < 0.05)。观察组及对照组产妇术后不同时点VAS评分水平均较干预前下降(均P < 0.05)，且观察组在术后1、3、5 d时VAS评分均低于对照组(均P < 0.01)。干预后，观察组健康知识水平、自我护理技能高于对照组，差异有统计学意义(均P < 0.05)，而自我概念、自护责任感差异无统计学意义(均P>0.05)。观察组产褥期感染率、产后尿潴留率、缺乳率、新生儿黄疸率、新生儿肺炎率均低于对照组，差异有统计学意义(均P < 0.05)。 结论 对剖宫产产妇应用激励式教育联合中医适宜技术，可提升产妇自我管理能力，消除负面情绪，改善母婴结局，减少并发症。 Abstract:Objective Applying motivational health education combined with appropriate technology of traditional Chinese medicine to cesarean section laboring women to explore the nursing effect. Methods The data of 150 cases of pregnant women undergoing cesarean delivery in Lishui Traditional Chinese Medicine Hospital's maternity checkups from January 2019 to December 2021 were selected for prospective analysis, and divided into a control group (60 cases, with motivational health education carried out in January 2019 to June 2020) and an observation group (90 cases, with motivational health education combined with appropriate technology of traditional Chinese medicine in July 2020 to December 2021) according to the time period of the development of clinical nursing care. The two groups were compared in terms of labor and delivery outcomes, rehabilitation, pain, emotional management, and maternal and infant complications. Results There was no statistically significant difference between the two groups in terms of 2 h postpartum hemorrhage (P>0.05), and the postoperative time of exhaustion in the observation group was lower than that in the control group [(1.92±0.64) d vs. (2.93±0.80) d], while the newborn Apgar score was higher than that in the control group [(9.03±1.69) points vs. (7.75±1.70) points], and the differences were statistically significant in all cases (all P < 0.05). The levels of maternal VAS scores at different postoperative time points in the two groups were down-regulated compared with the pre-intervention level (all P < 0.05), and the observation group had lower VAS scores than the control group at 1 day, 3 days, and 5 days post operation (all P < 0.01). After the intervention, the observation health knowledge level and self-care skills difference group were higher than the control group, and the difference was statistically significant (all P < 0.05), while the difference in self-concept and sense of self-care responsibility was not statistically significant (all P>0.05). The rates of puerperal infection, postpartum urinary retention, breast milk deficiency, neonatal jaundice, and neonatal pneumonia in the observation group were lower than those in the control group, and the differences were statistically significant (all P < 0.05). Conclusion The application of incentive education combined with appropriate technology of traditional Chinese medicine can improve the self-management ability of parturient women, eliminate negative emotions, improve maternal and infant outcomes and reduce complications. -
表 1 2组产妇基线资料比较
Table 1. Baseline data comparison between two groups of parturients
组别 例数 文化程度[例(%)] BMI
(x±s)孕周
(x±s，周)年龄
(x±s，岁)初中及以下 高中及以上 本科及以上 对照组 60 10(16.67) 23(38.33) 27(45.00) 27.80±1.38 38.45±1.50 26.32±4.65 观察组 90 15(16.67) 26(28.89) 49(54.44) 27.94±1.17 38.24±1.52 27.13±5.18 统计量 1.617a 0.667b 0.814b 0.985b P值 0.446 0.506 0.417 0.326 注：a为Z值，b为t值。 
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表 2 2组产妇分娩结局及康复情况比较(x±s)
Table 2. Comparison of delivery outcome and recovery between the two groups of parturients(x±s)
组别 例数 术后排气时间
(d)产后2 h出血量(mL) 新生儿Apgar评分
(分)对照组 60 2.93±0.80 330.55±13.67 7.75±1.70 观察组 90 1.92±0.64 326.83±15.02 9.03±1.69 t值 8.198 1.540 -4.534 P值 < 0.001 0.126 < 0.001
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表 3 2组产妇VAS评分比较(x±s，分)
Table 3. Comparison of VAS scores between two groups in parturients (x±s, points)
组别 例数 术前 术后1 d 术后3 d 术后5 d 对照组 60 8.95±0.65 7.97±0.66a 6.32±0.95ab 3.50±0.50ab 观察组 90 9.06±0.71 5.94±0.71a 4.96±0.65ab 2.12±0.68ab F值 0.924 17.561 9.700 13.361 P值 0.357 < 0.001 < 0.001 < 0.001 注: 与同组术前比较，aP < 0.05;与同组术后1 d比较，bP < 0.05。
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表 4 2组产妇自我管理情况比较(x±s，分)
Table 4. Comparison of self-management between two groups in parturients(x±s, points)
组别 例数 健康知识水平 自我概念 自护责任感 自我护理技能 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 对照组 60 51.85±4.34 68.48±2.86a 18.12±2.15 25.05±2.08a 15.97±1.15 21.90±0.73a 31.12±2.44 36.38±1.73a 观察组 90 52.82±4.42 74.38±4.19a 17.62±2.77 25.41±2.18a 16.26±1.26 22.06±0.66a 30.49±2.92 42.18±1.76a t值 1.326 10.253 1.181 1.013 1.429 1.356 1.380 19.865 P值 0.187 < 0.001 0.240 0.313 0.155 0.177 0.170 < 0.001 注: 与同组干预前比较，aP < 0.05。
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表 5 2组产妇情绪管理情况比较(x±s，分)
Table 5. Comparison of emotional management between two groups in parturients(x±s, points)
组别 例数 SAS评分 SDS评分 干预前 干预后 干预前 干预后 对照组 60 62.72±6.90 48.47±1.90a 61.43±3.43 47.23±3.79a 观察组 90 63.79±6.55 40.21±3.17a 60.79±3.82 40.66±2.90a t值 0.959 19.913 1.054 11.405 P值 0.339 < 0.001 0.294 < 0.001 注: 与同组干预前比较，aP < 0.05。
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表 6 2组产妇母婴并发症发生情况比较[例(%)]
Table 6. Comparison of maternal and infant complications between 2 groups of parturients [cases(%)]
组别 例数 产褥期感染 产后尿潴留 缺乳 新生儿黄疸 新生儿肺炎 有 无 有 无 有 无 有 无 有 无 对照组 60 8(13.33) 52(86.67) 12(20.00) 48(80.00) 26(43.33) 34(56.67) 11(18.33) 49(81.67) 3(5.00) 57(95.00) 观察组 90 3(3.33) 87(96.67) 4(4.44) 86(95.56) 8(8.89) 82(91.11) 6(6.67) 84(93.33) 0 90(100.00) χ2值 5.298 7.582 24.366 4.876 4.592 P值 0.021 0.005 < 0.001 0.027 0.032
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