中医护理干预对剖宫产术后PCIA镇痛效果及康复促进的临床观察

目的:观察剖宫产术后PCIA采用中医护理干预对镇痛及产妇康复促进的影响。方法:选择我院2017年8月至2018年6月符合入选条件的足月孕初产妇在蛛网膜下腔麻醉下行剖宫产200例,术后均采用相同药物的静脉自控镇痛泵(PCIA)。术毕按照抛币法随机分为2组:对照组87例术后按照剖宫产术后常规护理,给予抗炎补液,去枕卧位、流质饮食以及促进早期活动。实验组113例术后在常规护理基础上早期介入中医护理干预,观察比较2组术后镇痛效果及产后恢复情况。结果:观察组镇痛效果明显优于对照组(P<0.05);观察组下床活动时间、首次肠鸣音恢复时间、首次肛门排气时间明显短于对照组(P<0.01);两组产妇术后各时间节点阴道出血量比较差异有统计学意义(P<0.01),两组产妇术后24小时、72小时宫底高度差异有统计学意义(P<0.01),观察组产妇子宫复旧情况优于对照组。结论:剖宫产术后PCIA早期介入中医护理干预方法,在提高镇痛效果的基础上,有效降低术后PCIA的并发症,使产妇早期活动有利于产后康复,值得临床推广。

Clinical Observation on Analgesic Effect and Rehabilitation Promotion of PCIA after Cesarean Section by Nursing Intervention of Traditional Chinese Medicine

Objective:To evaluate the effect of PCIA on analgesia and maternal rehabilitation after cesarean section.Methods:A total of 200 cases of cesarean delivery under subarachnoid anaesthesia were selected for the first pregnant women with full-term pregnancy who met the inclusion criteria from August 2017 to June 2018 in our hospital.After surgery,the patients were randomly divided into two groups according to the coin toss method:the controlled group consisted of 87 patients who received routine postoperative care according to cesarean section,who were given anti-inflammatory rehydration,sleeper repose,liquid diet and early activities.In the experimental group,113 patients received early intervention of traditional Chinese medicine nursing intervention on the basis of routine nursing care,and the analgesic effect and postpartum recovery of the two groups were observed and compared.Results:The analgesic effect of the observation group was significantly better than that of the controlled group(P<0.05).The observation group was significantly shorter than the controlled group(P<0.01).There were statistically significant differences in vaginal blood loss at all time points after obstetrics and gynecology between the two groups(P<0.01),and statistically significant differences in fundal height at 24 h and 72 h after obstetrics and gynecology between the two groups(P<0.01).Maternal uterine relapse in the observation group was superior to the controlled group.Conclusion:PCIA’s early intervention of traditional Chinese medicine nursing intervention after cesarean section can effectively reduce postoperative PCIA complications on the basis of improving the analgesic effect,making early maternal activities conducive to postpartum rehabilitation and worthy of clinical promotion.