ICP孕妇阴道产时监护与护理体会.docVIP

ICP孕妇阴道产时监护与护理体会 　　[摘要] 目的:探讨妊娠期肝内胆汁淤积症(Intrahepatic Cholestasis of Pregnancy, ICP)阴道分娩时的监护与护理。方法:对2005年8月～2008年8月在我院行阴道分娩的45 例ICP 孕妇作为研究组进行回顾性分析,与同期45 例阴道分娩孕妇作为对照组进行比较。结果:实验组胎儿宫内窘迫、新生儿窒息发生率分别为39.1%、11.1%,与对照组比较差异有显著性意义(P0.01和P0.05),产后出血发生率为13.3%与对照组比较差异有显著性意义(P0.05)。结论:要加强ICP 孕妇的产时监护与护理观察,做好防范产后出血和新生儿窒息复苏措施,才能减少分娩并发症,提高产科质量。 　　[关键词] 妊娠期胆汁淤积症;阴道分娩;监护;护理 　　[中图分类号] R473.71[文献标识码]B [文章编号]1673-7210(2009)07(b)-094-02 　　 　　Discussion on the monitoring and nursing of the vaginal delivery in intrahepatic cholestasis of pregnancy 　　ZHU Hongmei 　　(Zhejiang Xiaoshan Hospital, Hangzhou 311201,China) 　　[Abstract] Objective:To discuss the monitoring and nursing of the vaginal delivery in intrahepatic cholestasis of pregnancy(ICP). Methods:45 ICP pregnant women as study group were retrospectively analyzed in our hospital underlying vaginal delivery in August 2005 to August 2008. Results:The incidence of intrauteral fetal distress and neonatal asphyxia in the study group were 39.1% and 11.1%,respectively. The difference was statistically significance comparing with the control group(P0.01 and P0.05);the incidence of puerperal hemorrhage, 13.3%,was also significantly different with the control group(P0.05). Conclusion:The monitoring and the nursing observation during delivery in the ICP patients should be intensified to prevent the puerperal hemorrhage and neonatal asphyxia,reduce the complication of the delivery,and improve the nursing quality in obstetrics. 　　[Key words] Intrahepatic cholestasis of pregnancy;Vaginal delivery;Mornitoring;Nursing 　　 　　妊娠期肝内胆汁淤积症(ICP)是妊娠中、晚期特有的并发症,临床上以皮肤瘙痒和黄疸为特征,主要危害胎儿,使围生儿发病率和死亡率增高。其发病率为0.8%～12.0%[1]。死胎、死产是ICP 严重的并发症,在临床工作中已引起产科医务人员的高度重视。本研究是对我院2005 年8 月～2008 年8月阴道分娩的45例ICP 患者作回顾性分析,探讨ICP孕妇阴道分娩时的监护与护理对策。 　　1对象与方法 　　1.1对象 　　2005年8月～2008年8月在我院阴道分娩的ICP孕妇共45例作为研究组,并随机选择同期45例阴道分娩孕妇作为对照组进行比较,两组孕妇年龄20～34岁,孕周35～40周。 　　1.2方法 　　用SPSS13.0统计软件,采用χ2检验。 　　2 结果 　　2.1两组围生儿结局比较分析 　　见表1。研究组胎儿宫内窘迫、新生儿窒息发生率分别为39.1%、11.1%,与对照组比较差异有显著性(P0.01和P0.05)。