Evaluation of the effects of proactive nursing care on postpartum hemorrhage in mothers who undergo vaginal delivery
阴道分娩产妇护理中实施预见性护理的效果对孕妇产后出血的影响评价

摘要

目的 本研究聚焦于预见性护理模式在阴道分娩产妇照护中的应用价值，着重探讨其对产后出血（PPH）发生率与血量控制的具体影响。方法 本研究选取2024年9月至2025年9月本医院产科接收的120例初产妇作为研究对象，采用随机分层抽样法将样本均等分配至实验组（n=60）和对照组（n=60）。对照组实施常规产科护理方案，实验组则在基础护理基础上融入基于风险评估的预见性护理干预措施。对比分析两组在产后2小时及24小时的出血量差异、整体出血发生率、护理前后焦虑自评量表（SAS）评分的变化情况，并综合评价患者的护理满意度。结果 实验组产后2小时（152.3±25.6 mL vs. 210.5±32.1 mL）及24小时（287.4±41.2 mL vs. 365.8±50.3 mL）出血量均低于对照组（P<0.05）。实验组的产后出血发生率仅为3.33%，远低于对照组的13.33%（χ2=4.904，P<0.05）。护理后，实验组SAS评分（38.5±4.2分）明显低于对照组（46.7±5.1分，P<0.05）。从患者反馈来看，实验组阴道分娩产妇在综合护理满意度方面达到96.67%，显著高于对照组阴道分娩产妇的83.33%（P<0.05）。结论 将前瞻性护理理念应用到阴道分娩产妇的临床管理当中，既可以有效地识别出高危因素，又可以减少术后出血的情况发生，还能改善围生期健康水平、提高心理适应能力，而且能够提升医疗服务的整体感受，有广阔的前景和现实意义。

Abstract

Objective This study focuses on the application value of the predictive nursing model in the care of women undergoing vaginal delivery, with an emphasis on its specific impact on the incidence and volume control of postpartum hemorrhage (PPH).
Methods A total of 120 primiparas admitted to the obstetrics department of our hospital from September 2024 to September 2025 were selected as study subjects. Using random stratified sampling, the samples were equally allocated to the experimental group (n=60) and the control group (n=60). The control group received conventional obstetric nursing care, while the experimental group received predictive nursing interventions based on risk assessment in addition to standard care. The differences in bleeding volume at 2 hours and 24 hours postpartum, overall bleeding incidence, changes in self-rated anxiety scores (SAS) before and after nursing intervention, and patient satisfaction with nursing care were compared and analyzed.
Results The bleeding volume in the experimental group was significantly lower than that in the control group at both 2 hours (152.3±25.6 mL vs. 210.5±32.1 mL) and 24 hours postpartum (287.4±41.2 mL vs. 365.8±50.3 mL; P<0.05). The PPH incidence in the experimental group was only 3.33%, significantly lower than the 13.33% in the control group (χ2=4.904, P<0.05). Post-intervention, the SAS scores in the experimental group (38.5±4.2) were markedly lower than those in the control group (46.7±5.1; P<0.05). According to patient feedback, mothers in the experimental group who underwent vaginal delivery achieved a comprehensive nursing satisfaction rate of 96.67%, significantly higher than the 83.33% rate in the control group (P<0.05).
Conclusion   Applying the prospective nursing approach to the clinical management of vaginal delivery mothers enables effective identification of high-risk factors, reduces postoperative bleeding, improves perinatal health outcomes, enhances psychological adaptation, and elevates overall satisfaction with medical services, demonstrating broad prospects and practical significance.