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[摘要] 目的 探讨综合性医院足月妊娠合并精神分裂症发作期患者采用多学科团队的护理方式对患者、家属及医护人员的安全性。 方法 2013年12月～2017年3月对13例足月妊娠合并精神分裂症发作期患者的术前护理情况、分娩情况和新生儿出生情况进行分析。 结果 13例患者均行剖宫产分娩（100.00%），无不良妊娠结局。足月产13例，术后新生儿出生Apgar评分8～10分，所有新生儿均无先天性疾病。产妇在手术复苏间观察2 h后情况良好，均顺利转入精神科病区治疗，术后7～10 d会诊无产褥期并发症发生。 结论 综合性医院足月妊娠合并精神分裂症发作期患者术前护理采用多学科团队的护理方式，主要包括：分娩方案的选择、麻醉方式的确定、医患双方恐惧心理的消除、多科合作的及时正确评估，适当放宽剖宫产指征，以保障母婴安全。
[关键词] 妊娠；分娩；精神病；急性期；护理管理
[中图分类号] R473.7 [文献标识码] B [文章编号] 1673-9701（2018）19-0150-03
Preoperative nursing care of 13 pregnant women with full-term pregnancy complicated with attacks of schizophrenia
WAN Ru QIAN Yuanfang LIU Xuezhen
Department of Obstetrics， Zhejiang Provincial Tongde Hospital， Hangzhou 310012， China
[Abstract] Objective To investigate the multi-disciplinary team nursing care for the patients with full-term pregnancy complicated with attacks of schizophrenia and its safety for patients， family members and medical staff. Methods Preoperative nursing care， delivery and neonatal births in 13 full-term pregnant women with attacks of schizophrenia were analyzed from December 2013 to March 2017. Results All 13 patients were given cesarean delivery （100.00%）， and no adverse pregnancy outcome was detected. There were 13 cases of full-term birth， and the postoperative neonatal Apgar score was 8-10 points. None of the newborns had congenital diseases. The puerpera were in good conditions who were observed 2 hours during surgical recovery， and they were successfully transferred to psychiatric ward for treatment. 7-10 days after surgery， there were no puerperal complications after consultation. Conclusion Preoperative nursing care in the patients with full-term pregnancy complicated with schizophrenia in general hospitals adopts multi-disciplinary team nursing approach， including： selection of delivery protocol， determination of anesthesia methods， elimination of the fear for both patients and doctors， timely and correct assessment of multidisciplinary cooperation， and appropriate relaxation of Cesarean indications， so as to protect the safety of mothers and children.
[Key words] Pregnancy； Delivery； Mental diseases； Acute stage； Nursing management
精神分裂癥是以基本的个性改变，思维、情感、行为的分裂，精神活动与环境的不协调为主要特征的一类精神病，一般无智能障碍和意识障碍[1]，是精神病中最常见的一种。妊娠合并精神分裂症在一般医院的产科临床实际工作中并不多见，特别是精神分裂症发作期的患者更少见。由于妊娠合并精神分裂症对孕妇本身、胎儿以及周围人群都可以造成危害，因此对足月妊娠合并精神分裂症发作期患者的治疗和护理特别需要产科医护人员加以关注。我科在2013年12月～2017年3月共收治了13例足月妊娠合并精神分裂症发作期的孕妇，现报道如下。
1 资料与方法
1.1 一般资料
足月妊娠合并精神分裂症发作期的患者13例，年龄19～41岁，平均29.26岁，病程3～11年，孕周37～41周；初产妇9例，经产妇4例，均为单胎。排除严重躯体器质性病变及产科并发症患者。
[关键词] 妊娠；分娩；精神病；急性期；护理管理
[中图分类号] R473.7 [文献标识码] B [文章编号] 1673-9701（2018）19-0150-03
Preoperative nursing care of 13 pregnant women with full-term pregnancy complicated with attacks of schizophrenia
WAN Ru QIAN Yuanfang LIU Xuezhen
Department of Obstetrics， Zhejiang Provincial Tongde Hospital， Hangzhou 310012， China
[Abstract] Objective To investigate the multi-disciplinary team nursing care for the patients with full-term pregnancy complicated with attacks of schizophrenia and its safety for patients， family members and medical staff. Methods Preoperative nursing care， delivery and neonatal births in 13 full-term pregnant women with attacks of schizophrenia were analyzed from December 2013 to March 2017. Results All 13 patients were given cesarean delivery （100.00%）， and no adverse pregnancy outcome was detected. There were 13 cases of full-term birth， and the postoperative neonatal Apgar score was 8-10 points. None of the newborns had congenital diseases. The puerpera were in good conditions who were observed 2 hours during surgical recovery， and they were successfully transferred to psychiatric ward for treatment. 7-10 days after surgery， there were no puerperal complications after consultation. Conclusion Preoperative nursing care in the patients with full-term pregnancy complicated with schizophrenia in general hospitals adopts multi-disciplinary team nursing approach， including： selection of delivery protocol， determination of anesthesia methods， elimination of the fear for both patients and doctors， timely and correct assessment of multidisciplinary cooperation， and appropriate relaxation of Cesarean indications， so as to protect the safety of mothers and children.
[Key words] Pregnancy； Delivery； Mental diseases； Acute stage； Nursing management
精神分裂癥是以基本的个性改变，思维、情感、行为的分裂，精神活动与环境的不协调为主要特征的一类精神病，一般无智能障碍和意识障碍[1]，是精神病中最常见的一种。妊娠合并精神分裂症在一般医院的产科临床实际工作中并不多见，特别是精神分裂症发作期的患者更少见。由于妊娠合并精神分裂症对孕妇本身、胎儿以及周围人群都可以造成危害，因此对足月妊娠合并精神分裂症发作期患者的治疗和护理特别需要产科医护人员加以关注。我科在2013年12月～2017年3月共收治了13例足月妊娠合并精神分裂症发作期的孕妇，现报道如下。
1 资料与方法
1.1 一般资料
足月妊娠合并精神分裂症发作期的患者13例，年龄19～41岁，平均29.26岁，病程3～11年，孕周37～41周；初产妇9例，经产妇4例，均为单胎。排除严重躯体器质性病变及产科并发症患者。