建立自然分娩临床护理路径联合4T高危因素评估对预防产后出血观察.docVIP

建立自然分娩临床护理路径联合4T高危因素评估对预防产后出血观察【摘 要】 目的：观察建立自然分娩临床护理路径联合4T高危因素评估对预防产后出血的临床效果。方法：将我院2009年1月1日至2009年12月31日未进行临床护理路径管理的自然临产阴道分娩的产妇676人为对照组，2010年1月1日至2010年12月31日进行临床护理路径管理的自然临产阴道分娩产妇692人为观察组，对两组产后出血量、产后出血发生率进行比较。结果：观察组产后出血发生率（1.45%）明显低于对照组（3.11%），差异有显著意义（p＜0.05）； 观察组产后出血病例产后出血量648.56±136.48ml，对照组产后出血量986.84±368.53ml，差异有显著意义（p＜0.01）。结论：建立自然分娩临床护理路径联合4T高危因素评估可有效减少产后出血的发生。 【关键词】自然分娩 临床护理路径 4T高危因素 产后出血 Observation on Establishing a Natural Birth Clinical Nursing Path United 4T Risk Factors Assessment in the Prevention of Postpartum Hemorrhage Wu lili Obstetrics，Guangxi Qinzhou No.2 Peoples Hospital Qinzhou 535000 【Abstract】Objective To observe the effect of establishing a natural birth clinical nursing path united 4T risk factors assessment in the prevention of postpartum hemorrhage. Method Control group is 676 people, observation group is 692 people, compare the incidence and amount of postpartum hemorrhage in the control group and observation group .Conclusion The incidence of postpartum hemorrhage (1.45%) in observation group was significantly lower than the control group (3.11%), the difference was significant (p＜0.05); postpartum hemorrhage observation group compared with the control group, the amount of bleeding of the observation group was (648.56 ± 136.48) ml, control group was (986.84 ± 368.53) ml, the difference was statistically significant (p＜0.01). Result Clinical nursing path to establish a natural childbirth United 4T risk factors assessment can effectively reduce the occurence of postpartum hemorrhage. 【Key words】Natural childbirth;Clinical nursing path;4T risk factors;Postpartum hemorrhage 产后出血（postpartum hemorrhage，PPH）是全世界孕产妇死亡的最主要原因，而近一半的产后出血死亡发生在发展中国家[1]。PPH的病因文献[2]认为包括4方面，即“4T”（子宫收缩异常Tone、妊娠相关物残留Tissue、生殖道创伤Trauma、凝血功能障碍Thrombin），它们都有各自的危险因素，产前识别出来并给予针对性的处理，可明显降低PPH的发生率、出血量。我院是北部湾沿海地区的三级甲等医院，承担着重度危重人群的产科保健、分娩任务及承担接受基层医院上送的高危孕产妇转诊、治疗、护理等工作，为了提高我院产科质量，降低产后出血发生率，根据卫生部办公厅文件（卫办医政发[2009]171号）中自然临产阴道分娩临床路径和医院工作具体情况，制定了自然分娩具体实施的临床护理路径，按