中外正常分娩护理常规比较-课件

1、中外正常分娩护理常规比较1ppt课件中外正常分娩护理常规比较1ppt课件教学目标 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2ppt课件教学目标 一.明确国际正常分娩实践标准2ppt课件循证护理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 3ppt课件循证护理EVIDENCE-BASED NURSING 分娩对产妇及胎儿有害需要禁止的措施1.Routine episiotomy is associa

2、ted 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。http:/www.liv.ac.uk/4ppt课件对产妇及胎儿有害需要禁止的措施1.Routine epis5ppt课件5ppt课件选择性（限制应用）会阴切开术结果分析No increase in incidence of major outcomes (e.g., severe vaginal

3、 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.)6ppt课件选择性（限制应用）会阴切开术结果分析No increase 对产妇及胎儿有害

4、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。7ppt课件对产妇及胎儿有害需要禁止的措施2.Routine enema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. T

5、his 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。8ppt课件对产妇及胎儿有害需要禁止的措施3.Perineal shav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。9ppt课件对产妇及胎儿有害需要禁止的措施5.Routine artif6.Supine positi

6、on 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10ppt课件6.Supine position for delivery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.Encoura

7、ging 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11ppt课件不恰当应当避免的措施7.Routinely moving 有利应提倡的措施1.Companionship provided by a family member or lay carer during labour. This improves maternal satisfaction,

8、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。12ppt课件有利应提倡的措施1.Companionship provid有利应提倡的措施2.Being mobile during labour. This shortens labour and reduces the need for pain relief an

9、d 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13ppt课件有利应提倡的措施2.Being mobile during 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 c

10、lean at delivery. Poor hygiene is associated with neonatal tetanus and sepsis. 无菌断脐14ppt课件有利应提倡的措施3.Routine antibiotics 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 c

11、lean 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15ppt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15ppt课有益的措施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）16ppt课件有益的措施Delayed push16ppt课件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 uprigh