妊娠期梅毒患者的孕期护理干预

摘要

Objective To explore the nursing intervention on the pregnant women with syphilis during pregnancy so as to reduce the harm to maternal and baby.Methods Many information such as age,occupation,dwelling environment,marriage and sexual life,curing during pregnancy,pregnant and perinatal infant outcome from medical records were reviewed. Gestational syphilis women of 847 cases were randomly divided into nursing intervention group with 427 cases and control group with 420 cases.Nursing intervention group received one-by-one psychological care and health education,got cooperation from families,and received routine blood test and cure cooperation,while control group only received routine blood test and curing cooperation.Patients were followed up for seven days.Results The rate of adherence to treatment in nursing intervention group was 98.1％ which was significantly higher than 61.7％ in control group ( x2 =176.2,P ＜ 0.01 ),and the rate of accepting standard treatment between early and late pregnancy,middle and late pregnancy were significantly higher than that in control group ( x2 =17.8,P ＜ 0.01 ).The week was shorter for receiving nursing intervention and the patients' compliance was better ( P ＜ 0.01 ). Only 23 syphilis infection babies in the nursing intervention group were born,but 149 babies in control group were infected by syphilis,and the difference was significantly different( x2 =123.2,P ＜ 0.01 ).Conclusions Nursing intervention can effectively increase the compliance of pregnant women with syphilis and improve the outcome of pregnancy and perinatal infant.%目的 探讨妊娠期梅毒的孕期护理干预方法,减少其对母婴的危害.方法 采集病史资料,调查内容包括年龄、职业、居住环境、婚姻、性行为方式、孕期治疗情况、妊娠结局和围生儿结局等.对初次产前检查的孕妇,在知情同意下行梅毒血清学快速血浆反应素环状卡片试验(rapid plasma reagin test,RPR)筛查,凡RPR阳性者均进一步检测RPR滴度,并以梅毒密螺旋体血凝试验(treponema pallidum hemagglutination assay,TPHA)检测加以确诊.将确诊为妊娠期梅毒感染者847例随机分为孕期护理干预组427例和对照组420例.孕期护理干预组按一对一健康教育提供相关知识,进行一次家庭成员的面谈以取得配合,常规检测和治疗配合；同期对照组仅常规检测和治疗配合.两组均跟踪随访至产后7d.结果 干预组接受治疗的依从性(98.1％)远高于对照组(61.7％),其中接受孕早晚期规范治疗和孕中晚期2个疗程治疗的也高于对照组,差异均有统计学意义(x2分别为176.2,17.8;P均＜0.01).实施孕期护理干预的孕周越小,接受规范治疗的依从性越好(P＜0.01).干预组发生先天性梅毒感染的围生儿23例,少于对照组的149例,差异有统计学意义(x2=123.2,P＜0.01).结论 对妊娠期梅毒患者实施健康教育,可有效提高其接受治疗的依从性,从而有效地改善妊娠、围生儿结局,减少对母婴的危害.