目的：总结对头位胎膜早破的孕妇临产后体位护理要点。方法将我院于2015年2月～2016年2月间收治的58例胎膜早破孕妇，随机将其划分为对照组29例与干预组29例，对照组孕妇接受常规护理指导工作，包括遵医嘱绝对卧床休息，当胎儿头先露处接近胎头颅骨的最低点时，指导产妇离床活动；实验组孕妇在接受阴道检查后发现胎先露达到坐骨棘以上两横指以下时，胎儿头部尚未抬头，且不排除有脐带先露情况，指导孕妇离床活动。观察两组孕妇产分娩结局、护理服务治疗评价、产程用时等。结果对照组孕妇总产程用时较多，干预组较少（P＜0.05）。对照组孕妇对于临床提供的基础护理、皮肤清洁、知识宣教及心理疏导等指标评分均较低，干预组较高（P＜0.05）。对照组出现产褥感染、胎儿宫内窘迫、新生儿窒息等发生率分别为13.79%、17.24%、13.79%；干预组上述分别为3.45%、6.90%、3.45%，干预组较低（P＜0.05）。结论对于胎膜早破临产后的孕妇，为其提供院内常规护理措施基础上增加体位干预，大部分孕妇总产程用时较少且对临床护理服务质量评价较高，分娩结局较好。%Objective To summarize body position nursing gor pregnant women with premature rupture of fetal membranes of head position. Methods 58 pregnant women with premature rupture of membranes cured in our hospital from February 2015 to February 2016 were selected. They were randomly divided into control group and intervention group with 29 cases each group. Patients in control group were treated with the conventional nursing care like absolute bed rest, when the fetal head was close to the deepest point, it was necessary to ask the pregnant women to do the activities out of bed. Patients in intervention group were treated with special nursing care, after the vaginal examination, the fetal presentation was in the first labor stage without the appearance of fetal head (the presentation of cord was not excluded), it was necessary to ask the pregnant women to do the activities out of bed. The delivery outcome, nursing service and labor duration for two groups was observed. Results The overall labor duration for control group was longer than that of intervention group (P < 0.05). The evaluation score of basic nursing, skin cleaning, child-bearing knowledge and psychological counseling of control group was lower than that of intervention group (P < 0.05). The incidence rate of puerperal infection, fetal distress, neonatal asphyxia for control group was 13.79%, 17.24%and 13.79%. The rate for intervention group was 3.45%, 6.90%and 3.45%(P<0.05). Conclusion For pregnant women with premature rupture of membranes, the conventional nursing care and delivery position guidance can shorten the labor duration, enhance the nursing service quality, and improve the delivery outcome.
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