唐秋霞 劉春梅
[摘要]目的 探討改良積血墊在陰道分娩中的應(yīng)用。方法 選取2019年1~12月我院收治的120例陰道分娩產(chǎn)婦,按照分娩時(shí)間順序隨機(jī)分組法,分為對(duì)照組及研究組,各60例。對(duì)照組使用普通護(hù)理墊計(jì)量出血量,研究組使用改良積血墊計(jì)量出血量。比較兩組分娩時(shí)出血量計(jì)量準(zhǔn)確率、血液側(cè)漏率、醫(yī)務(wù)人員職業(yè)暴露率、產(chǎn)婦及醫(yī)務(wù)人員滿意度。結(jié)果 研究組測得分娩時(shí)出血量計(jì)量準(zhǔn)確率高于對(duì)照組,血液側(cè)漏、醫(yī)務(wù)人員職業(yè)暴露發(fā)生率均低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);研究組產(chǎn)婦及醫(yī)務(wù)人員滿意度均高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 改良積血墊在陰道分娩中,可精確計(jì)量分娩時(shí)出血量,有效降低血液側(cè)漏及醫(yī)務(wù)人員職業(yè)暴露發(fā)生率,可保障產(chǎn)婦及醫(yī)務(wù)人員安全,利于提高醫(yī)護(hù)人員及產(chǎn)婦滿意度。
[關(guān)鍵詞]陰道分娩;改良積血墊;設(shè)計(jì);應(yīng)用價(jià)值
[中圖分類號(hào)] R714.3? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-4721(2020)8(a)-0124-04
Application of improved hematocele pad in vaginal delivery
TANG Qiu-xia1? ?LIU Chun-mei2
1. Department of Obstetrics and Gynecology, Ganzhou Municipal Hospital, Jiangxi Province, Ganzhou? ?341000, China; 2. Department of Internal Medicine, Ganzhou Municipal Hospital, Jiangxi Province, Ganzhou? ?341000, China
[Abstract] Objective To investigate the application of improved hematocele pad in vaginal delivery. Methods A total of 120 pregnant women with vaginal delivery who were admitted to our hospital from January to December 2019 were selected as the research subjects. All pregnant women were divided into the control group and the research group according to the time sequence of delivery, with 60 cases in each group. The control group was given general nursing pad to measure the bleeding volume, and the research group was given improved hematocele pad to measure the bleeding volume. The accuracy of measurement of bleeding volume on delivery, side leakage rate of blood, occupational exposure rate of medical staff, satisfaction of pregnant women and medical staff were compared between the two groups. Results The accuracy of measurement of bleeding volume on delivery in the research group was higher than that in the control group, and the incidence of side leakage of blood and occupational exposure of medical staff in the research group was lower than that in the control group, and the differences were statistically significant (P<0.05). The satisfaction of pregnant women and medical staff in research group was higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Improved hematocele pad in vaginal delivery can accurately measure the bleeding volume on delivery, effectively reduce the incidence of side leakage of blood and occupational exposure of medical staff, guarantee the safety of pregnant women and medical staff, and improve the satisfaction of medical staff and pregnant women.
目前,產(chǎn)后出血成為孕婦死亡的主要原因之一,研究表明,大多數(shù)產(chǎn)后出血導(dǎo)致的孕婦死亡均可得到避免,其關(guān)鍵在于對(duì)產(chǎn)后出血進(jìn)行早期診斷,并做出正確處理[3-4]。臨床測量分娩時(shí)出血量往往與產(chǎn)婦實(shí)際出血量存在一定差異,可能會(huì)延誤搶救工作,導(dǎo)致產(chǎn)婦死亡[5-7]。因此,對(duì)產(chǎn)婦分娩時(shí)出血量的正確測量及評(píng)估、對(duì)產(chǎn)后出血的診斷及治療至關(guān)重要。
以往臨床測量陰道分娩出血量,常采用普通護(hù)理墊進(jìn)行測量,雖然具有一定測量價(jià)值,但其其吸附力相對(duì)較弱,過程中血液可能側(cè)漏于產(chǎn)婦背部等,導(dǎo)致出血量計(jì)量誤差較大,繼而延誤最佳搶救時(shí)機(jī)[8-9]。此外,側(cè)漏的血液可能可能會(huì)污染到醫(yī)護(hù)人員工作衣,甚至污染到產(chǎn)房底面等,進(jìn)而增加醫(yī)務(wù)人員職業(yè)暴露的風(fēng)險(xiǎn)[10-11]。改良積血墊是一種可有效防止側(cè)漏,精確計(jì)量分娩時(shí)出血量的方式,其應(yīng)用在臨床中操作簡單,不僅可保證產(chǎn)婦安全,也可有效避免醫(yī)務(wù)人員職業(yè)暴露的發(fā)生。改良積血墊利用兒童紙尿褲設(shè)計(jì)包裹于產(chǎn)婦臀部,可有效防止血液側(cè)漏現(xiàn)象;利用魔術(shù)貼規(guī)定在產(chǎn)床掛腳架上,當(dāng)出血量較大,可使得積血墊難以吸附的血液順著凹槽流入下方漏斗型三角袋內(nèi),可避免醫(yī)務(wù)人員職業(yè)暴露現(xiàn)象。此外,改良積血墊在下方設(shè)計(jì)三角袋外標(biāo)注劑量刻度,有利于護(hù)理人員直接準(zhǔn)確觀察具體血流量,提高計(jì)量準(zhǔn)確性。本研究結(jié)果顯示,研究組測得分娩時(shí)出血量計(jì)量準(zhǔn)確率高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。研究組血液側(cè)漏、醫(yī)務(wù)人員職業(yè)暴露發(fā)生率均低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。產(chǎn)婦及醫(yī)務(wù)人員滿意度均高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。提示改良積血墊可精確測量分娩時(shí)出血量,有效防止血液側(cè)漏,利于降低醫(yī)務(wù)人員職業(yè)暴露發(fā)生率,對(duì)保障產(chǎn)婦生命安全及醫(yī)務(wù)人員執(zhí)業(yè)安全具有重要作用;同時(shí)其可提高產(chǎn)婦及醫(yī)務(wù)人員滿意度,分析其原因在于:改良積血墊的類似兒童紙尿褲的設(shè)計(jì)可有效防止血液向產(chǎn)床兩邊側(cè)漏、漏斗形三角袋設(shè)計(jì)可以直接計(jì)量出血量,兩者結(jié)合可以精確計(jì)量分娩中的出血量[12-13]。此外,防側(cè)漏設(shè)計(jì)可以減少醫(yī)源性污染,減少血液污染醫(yī)務(wù)人員的工作衣褲、鞋襪等,降低了職業(yè)暴露;漏斗型三角袋設(shè)計(jì)利于直接觀察出血量;積血墊吸血量大,可以減少更換頻率,節(jié)約醫(yī)療資源;使用方便,便于推廣[14-15]。
綜上所述,改良積血墊在陰道分娩中,可精確計(jì)量分娩時(shí)出血量,有效降低血液側(cè)漏及醫(yī)務(wù)人員職業(yè)暴露發(fā)生率,可保障產(chǎn)婦及醫(yī)務(wù)人員安全,利于提高醫(yī)護(hù)人員及產(chǎn)婦滿意度。
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(收稿日期:2020-02-11)