中外正常分娩护理常规比较-课件

,中外正常分娩护理常规比较 ppt课件,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,2009-5-5,中外正常分娩护理常规比较 ppt课件,*,中外正常分娩护理常规比较,中外正常分娩护理常规比较 ppt课件,2009-5-5,中外正常分娩护理常规比较中外正常分娩护理常规比较 ppt课,1,教学目标,一,.,明确国际正常分娩实践标准,1.,对产妇及胎儿有害需要禁止的措施,2.,有利应提倡的措施,二,.,讨论分析现有护理实践标准与国际标准间的不同，按国际标准操作的可行性与困难,中外正常分娩护理常规比较 ppt课件,教学目标 一.明确国际正常分娩实践标准中外正常分娩护理常规比,2,循证护理,EVIDENCE-BASED NURSING,分娩体位,:,妇女一定要仰卧位生孩子吗？,为什么？,为什么不？,第一产程,第二产程,中外正常分娩护理常规比较 ppt课件,循证护理EVIDENCE-BASED NURSING 分娩,3,对产妇及胎儿有害需要禁止的措施,1.Routine episiotomy is associated with poor healing, and longer hospital stays. Episiotomies should only be done where clinically required.,常规的会阴切开术带来愈合不良、住院时间延长等。,只有在有医学指征时才能应用会阴切开。,中外正常分娩护理常规比较 ppt课件,对产妇及胎儿有害需要禁止的措施1.Routine epis,4,中外正常分娩护理常规比较 ppt课件,中外正常分娩护理常规比较 ppt课件,5,选择性（限制应用）会阴切开术结果分析,No increase in incidence of major outcomes (e.g., severe vaginal or perineal trauma nor in pain, dyspareunia or urinary incontinence),不增加会阴裂伤、排尿困难，尿失禁（会阴松驰表现）,Incidence of 3rd degree tear reduced (1.2% with episiotomy, 0.4% without),会阴三度裂伤在常规会阴切开者为,1.2%,，在选择性应用中为,0.4%,(Carroli and Belizan 2000.Eason et al 2000; WHO 1999.),中外正常分娩护理常规比较 ppt课件,选择性（限制应用）会阴切开术结果分析No increase,6,对产妇及胎儿有害需要禁止的措施,2.Routine enemas. They are uncomfortable, make a mess, and are of no benefit. Enemas should be used only if requested.,常规的灌肠。,中外正常分娩护理常规比较 ppt课件,对产妇及胎儿有害需要禁止的措施2.Routine enema,7,对产妇及胎儿有害需要禁止的措施,3.Perineal shaving. This is degrading and of no demonstrable benefit.,剃除阴毛。没有益处，使产妇感到不舒适。,4.Withholding oral fluids. This is uncomfortable and unjustified.,分娩过程中限制喝水。这使产妇不舒适并没有证据。,中外正常分娩护理常规比较 ppt课件,对产妇及胎儿有害需要禁止的措施3.Perineal shav,8,对产妇及胎儿有害需要禁止的措施,5.Routine artificial rupture of the membranes (AROM). Painful, and of no value unless progress in labor is abnormal.,常规人工破膜。带来疼痛，对正常分娩无益。,中外正常分娩护理常规比较 ppt课件,对产妇及胎儿有害需要禁止的措施5.Routine artif,9,6.Supine position for delivery. Affects blood flow in the uterus and interferes with progress of second stage of labor.,仰卧位分娩,。这减少子宫血流供给并妨碍第二产程进 展,对产妇及胎儿有害需要禁止的措施,中外正常分娩护理常规比较 ppt课件,6.Supine position for delivery,10,不恰当应当避免的措施,7.Routinely moving laboring woman to a different room at onset of second stage,在第二产程常规的搬动产妇到另一房间（产房）,8.Encouraging woman to push when full dilation or nearly full dilation of cervix has been diagnosed, before woman feels urge to bear down,在产妇还不想用力时就指导产妇屏气用力,中外正常分娩护理常规比较 ppt课件,不恰当应当避免的措施7.Routinely moving,11,有利应提倡的措施,1.Companionship,provided by a family member or lay carer during labour. This improves maternal satisfaction, shortens labour and improves breastfeeding. It also reduces the need for pain relief and assisted delivery.,由家庭成员或专业人员提供陪伴分娩。这增加产妇满意度，缩短产程并增加母乳喂养成功率。减轻分娩时疼痛，并减少助产手术。,中外正常分娩护理常规比较 ppt课件,有利应提倡的措施1.Companionship provid,12,有利应提倡的措施,2.Being mobile,during labour. This shortens labour and reduces the need for pain relief and assisted deliveries.,产妇在产程中可自由活动。可缩短产程，减轻疼痛，减少助产手术。,第一产程和第二产程体位：自由体位，直立（坐，站，跪，蹲，手膝俯卧位），或侧卧位，避免仰卧位,*,截石位,中外正常分娩护理常规比较 ppt课件,有利应提倡的措施2.Being mobile during,13,有利应提倡的措施,3.Routine antibiotics for preterm, prelabour rupture of membranes,. They improve maternal and neonatal outcomes,早产儿常规应用抗菌素。,.,4.Keeping the umbilical cord clean,at delivery. Poor hygiene is associated with neonatal tetanus and sepsis.,无菌断脐,中外正常分娩护理常规比较 ppt课件,有利应提倡的措施3.Routine antibiotics,14,有利应提倡的措施,应用一次性无菌用物或重复消毒用品,手套，隔离衣，鞋，围裙，眼镜（防水，防血）,洗 手,Wash womans perineum with soap and water and keep it clean,用肥皂和清水清洗会阴部保持,清洁,Ensure that surface on which newborn is delivered is kept clean,保持新生儿娩出后在洁净的地方,High-level disinfect instruments, gauze and ties for cutting cord,严格无菌断脐,中外正常分娩护理常规比较 ppt课件,有利应提倡的措施应用一次性无菌用物或重复消毒用品中外正常分娩,15,有益的措施,Delayed push,第二产程晚用力,Delayed cord clamping,晚断脐（脐带搏动停止后或胎盘娩出后）,中外正常分娩护理常规比较 ppt课件,有益的措施Delayed push中外正常分娩护理常规比较,16,总结有益的措施中医分娩六字真言,睡，忍痛，慢临盆,Have a skilled attendant present,专业助产人员,*Use specific criteria to diagnose active labor,正确的判断活跃期（临产诊断,-,睡）,*Free of movement and upright position,Nutrition support *,饮食活动（忍痛）,*Delayed push(*,延迟用力）（慢临盆）,delayed cord clamping*,晚断脐,Restrict use of unnecessary interventions,限制不必要的措施（如会阴切开）,中外正常分娩护理常规比较 ppt课件,总结有益的措施中医分娩六字真言睡，忍痛，慢临盆Ha,17,