1、中外正常分娩護(hù)理常規(guī)比較1ppt課件中外正常分娩護(hù)理常規(guī)比較1ppt課件教學(xué)目標(biāo) 一.明確國(guó)際正常分娩實(shí)踐標(biāo)準(zhǔn) 1.對(duì)產(chǎn)婦及胎兒有害需要禁止的措施 2.有利應(yīng)提倡的措施二.討論分析現(xiàn)有護(hù)理實(shí)踐標(biāo)準(zhǔn)與國(guó)際標(biāo)準(zhǔn)間的不同，按國(guó)際標(biāo)準(zhǔn)操作的可行性與困難2ppt課件教學(xué)目標(biāo) 一.明確國(guó)際正常分娩實(shí)踐標(biāo)準(zhǔn)2ppt課件循證護(hù)理EVIDENCE-BASED NURSING 分娩體位: 婦女一定要仰臥位生孩子嗎？ 為什么？ 為什么不？第一產(chǎn)程第二產(chǎn)程 3ppt課件循證護(hù)理EVIDENCE-BASED NURSING 分娩對(duì)產(chǎn)婦及胎兒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. 常規(guī)的會(huì)陰切開術(shù)帶來(lái)愈合不良、住院時(shí)間延長(zhǎng)等。只有在有醫(yī)學(xué)指征時(shí)才能應(yīng)用會(huì)陰切開。http:/www.liv.ac.uk/4ppt課件對(duì)產(chǎn)婦及胎兒有害需要禁止的措施1.Routine epis5ppt課件5ppt課件選擇性（限制應(yīng)用）會(huì)陰切開術(shù)結(jié)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) 不增加會(huì)陰裂傷、排尿困難，尿失禁（會(huì)陰松馳表現(xiàn)） Incidence of 3rd degree tear reduced (1.2% with episiotomy, 0.4% without)會(huì)陰三度裂傷在常規(guī)會(huì)陰切開者為1.2% ，在選擇性應(yīng)用中為0.4% (Carroli and Belizan 2000.Eason et al 2000; WHO 1999.)6ppt課件選擇性（限制應(yīng)用）會(huì)陰切開術(shù)結(jié)果分析No increase 對(duì)產(chǎn)婦及胎兒有害

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. 常規(guī)的灌腸。7ppt課件對(duì)產(chǎn)婦及胎兒有害需要禁止的措施2.Routine enema對(duì)產(chǎn)婦及胎兒有害需要禁止的措施3.Perineal shaving. This is degrading and of no demonstrable benefit. 剃除陰毛。沒(méi)有益處，使產(chǎn)婦感到不舒適。4.Withholding oral fluids. T

5、his is uncomfortable and unjustified. 分娩過(guò)程中限制喝水。這使產(chǎn)婦不舒適并沒(méi)有證據(jù)。8ppt課件對(duì)產(chǎn)婦及胎兒有害需要禁止的措施3.Perineal shav對(duì)產(chǎn)婦及胎兒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. 常規(guī)人工破膜。帶來(lái)疼痛，對(duì)正常分娩無(wú)益。9ppt課件對(duì)產(chǎn)婦及胎兒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. 仰臥位分娩。這減少子宮血流供給并妨礙第二產(chǎn)程進(jìn) 展對(duì)產(chǎn)婦及胎兒有害需要禁止的措施10ppt課件6.Supine position for delivery不恰當(dāng)應(yīng)當(dāng)避免的措施7.Routinely moving laboring woman to a different room at onset of second stage在第二產(chǎn)程常規(guī)的搬動(dòng)產(chǎn)婦到另一房間（產(chǎn)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 在產(chǎn)婦還不想用力時(shí)就指導(dǎo)產(chǎn)婦屏氣用力11ppt課件不恰當(dāng)應(yīng)當(dāng)避免的措施7.Routinely moving 有利應(yīng)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. 由家庭成員或?qū)I(yè)人員提供陪伴分娩。這增加產(chǎn)婦滿意度，縮短產(chǎn)程并增加母乳喂養(yǎng)成功率。減輕分娩時(shí)疼痛，并減少助產(chǎn)手術(shù)。12ppt課件有利應(yīng)提倡的措施1.Companionship provid有利應(yīng)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. 產(chǎn)婦在產(chǎn)程中可自由活動(dòng)。可縮短產(chǎn)程，減輕疼痛，減少助產(chǎn)手術(shù)。第一產(chǎn)程和第二產(chǎn)程體位：自由體位，直立（坐，站，跪，蹲，手膝俯臥位），或側(cè)臥位，避免仰臥位*截石位13ppt課件有利應(yīng)提倡的措施2.Being mobile during 有利應(yīng)提倡的措施3.Routine antibiotics for preterm, prelabour rupture of membranes. They improve maternal and neonatal outcomes早產(chǎn)兒常規(guī)應(yīng)用抗菌素。. 4.Keeping the umbilical cord c

10、lean at delivery. Poor hygiene is associated with neonatal tetanus and sepsis. 無(wú)菌斷臍14ppt課件有利應(yīng)提倡的措施3.Routine antibiotics 有利應(yīng)提倡的措施應(yīng)用一次性無(wú)菌用物或重復(fù)消毒用品手套，隔離衣，鞋，圍裙，眼鏡（防水，防血）洗 手Wash womans perineum with soap and water and keep it clean用肥皂和清水清洗會(huì)陰部保持清潔Ensure that surface on which newborn is delivered is kept c

11、lean 保持新生兒娩出后在潔凈的地方High-level disinfect instruments, gauze and ties for cutting cord嚴(yán)格無(wú)菌斷臍15ppt課件有利應(yīng)提倡的措施應(yīng)用一次性無(wú)菌用物或重復(fù)消毒用品15ppt課有益的措施Delayed push第二產(chǎn)程晚用力Delayed cord clamping 晚斷臍（臍帶搏動(dòng)停止后或胎盤娩出后）16ppt課件有益的措施Delayed push16ppt課件總結(jié)有益的措施中醫(yī)分娩六字真言睡，忍痛，慢臨盆Have a skilled attendant present 專業(yè)助產(chǎn)人員*Use specific criteria to diagnose active labor 正確的判斷活躍期（臨產(chǎn)診斷-睡） *Free of movement and uprigh