58例多胎妊娠孕妇减胎术后妊娠结局分析及护理*

目的: 分析多胎妊娠减胎术后的妊娠结局并总结护理的要点。方法: 回顾性分析2016年1月至2018年12月行减胎术的58例多胎妊娠孕妇临床资料,术前对其进行心理护理、术后进行饮食及活动指导,分析减胎术后的妊娠结局。结果: 所有多胎妊娠均减至单胎或双胎,孕早期减胎与孕中期减胎比较,在术后2周内流产率、活产胎儿分娩孕周方面差异无统计学意义（P>0.05）,孕中期减胎较孕早期减胎新生儿出生体质量更重,差异有统计学意义（P<0.05）;心内注射氯化钾（KCl）减胎和射频消融（RFA）减胎两种手术方法比较,在术后2周内流产率、分娩孕周、围生儿存活率方面差异无统计学意义（P>0.05）。结论: 减胎术可在孕早中期进行,KCl减胎及RAF减胎均可改善多胎妊娠的妊娠结局。术前心理护理及术后饮食、活动指导,对妊娠结局有益。

Analysis of outcome for 58 cases of multifetal pregnancy reduction

Objective: To analyze the pregnancy outcome after reduction in multiple pregnancy and discuss the importance of nursing. Methods: Retrospective analysis was made on clinical data of 58 multiple pregnancy women who underwent fetal reduction from January 2016 to December 2018, including preoperative psychological care, postoperative diet and activity guidance, and pregnancy outcome. Results: All cases were reduced to single or twin. For reduction in first trimester vs in second trimester, the miscarriage within 2 weeks after surgery and the mean gestational age at delivery, had no significant difference(P>0.05), but the neonatal birth weights in second trimester were greater than in first trimester (P<0.05); For fetal reduction by potassium chloride(KCl) vs by radiofrequency ablation（RAF）, the miscarriage within 2 weeks after surgery, gestational age and the survival rate were no statistically significant differences(P>0.05). Conclusion: Multiple pregnancy reduction can be performed in the first and second trimester, both KCl and RAF reductions can improve pregnancy outcomes. Preoperative psychological care and postoperative diet and activity guidance are beneficial to pregnancy outcome.