循证护理在妊娠合并心力衰竭患者剖宫产围手术期护理的效果

目的：探讨循证护理在妊娠合并心力衰竭患者剖宫产围手术期护理的效果。方法选取住院的妊娠合并心力衰竭行剖宫产患者120例，随机分为对照组与观察组，每组60例。对照组给予常规的护理，观察组在此基础上给予循证护理。比较两组患者护理前后VAS评分、新生儿Apgar评分、并发症的发生率、护理满意度、血清肌酶谱、血清BNP水平、心理状况以及生活质量等。结果观察组产妇护理后VAS评分、并发症的发生率均明显低于对照组（均P＜0.01），新生儿Apgar评分、患者对护理工作的满意度均明显高于对照组（均P＜0.01）；血清肌酶谱及血清BNP水平与护理前比较均有明显改善（ P＜0.01），且与对照组比较均有明显改善（ P＜0.05）；心理状况与护理前比较均有明显改善（ P＜0.05），且与对照组比较均有明显改善（ P＜0.05）；QLQC-30得分明显高于对照组（ P＜0.05，P＜0.01）。结论循证护理能够显著地改善行剖宫产术的妊娠合并心力衰竭产妇的心理状况及生活质量，应在临床上加以推广并应用。

The effect of cesarean section perioperative period with evidence-based care in pa-tients with heart failure during pregnancy

Objective To investigate the perioperative care and its effects in pregnant women with heart failure underwent cesarean section.Methods A total of 120 cases of pregnant women with heart failure line cesarean section patients to stay in our hospital during 2007.06~2012.06 were randomly divided into control group and obser-vation group, each group was 60 cases.The control group was received conventional care, and the observation group was given evidence -based nursing on basis of the control group.VAS scores , Apgar score , incidence of complications , nursing satisfaction , serum muscle en-zymes, serum BNP levels, psychological conditions and quality of life were compared before and after nursing .Results （1） VAS score, Apgar score, and the incidence of complications and nursing satisfaction of the control group were respectively （7.4 ±1.3）, points, （7.6 ±1.9） points, 20.00%and 78.33%, and the above indexes of observation group were respectively （4.3 ±0.8） points, （9.7 ±2.3） points, 6.67%and 95.0%, and there was significantly statistical difference between the two groups （P0.05） , and there were statistical differences between the two groups （P〈0.05）;（4） The scores of the control group was lower than that of observation group （ P〈0.05 , P〈0.01 ） .Conclusions Evidence -based care could significantly improve maternal psychological status and quality of life of cesarean section pregnancy combined with heart failure , which should be promoted and applied in clinical practice.